What are the Minimally Invasive Options?


Over 90% of our patients are successfully managed with nonsurgical therapy such as rubber band ligation in the office. On occasion, however, the hemorrhoids are too large for these methods and a surgical procedure is needed. We offer modern and minimally invasive surgery which we feel results in earlier recovery with less pain than the traditional hemorrhoidectomy techniques.

Our most common technique uses a modern instrument called the Harmonic Scalpel in place of the traditional cold knife or hot cautery techniques. The Harmonic scalpel uses ultrasound technology to remove hemorrhoids with precision and seals the tissue at lower temperatures causing less injury and burn. The result is less pain, less swelling and easier recovery. 


Other minimally invasive techniques are used on selected patients based on the extent of your hemorrhoids and other patient factors.

PPH stapled hemorrhoidectomy is a technique that reduces the prolapse (enlargement) of hemorrhoidal tissue without cutting anal skin or placing painful stitches as is required with traditional hemorrhoid surgery. With the PPH procedure, patients have claimed to experience less pain and recover faster than those who undergo conventional hemorrhoidectomy. However, some patients may experience complications with chronic problems. We generally no longer offer this option.

PPH Stapled Hemorrhoidectomy

Transanal Hemorrhoidal Dearterialization (THD™)

THD™ uses a Doppler technology to allow the surgeon to locate some of the blood vessels of the hemorrhoids. The surgeon then ties off the blood supply using suture technique. Once the blood supply is cut off, the hemorrhoid will shrink and symptoms may resolve. Since no tissue is actually removed, the pain is typically less than the other techniques. However, some patients can have return of symptoms or may feel that the tissue s still present following the procedure. For these reasons, we generally do not offer this procedure very often.

What to Discuss with your Doctor

Constipation and straining are often the main causes of hemorrhoids.  Others get hemorrhoids after frequent episodes of diarrhea.  Hemorrhoids tend to run in families and you may be more likely to get them if your parents had them. Other factors include obesity, sitting too long on the toilet, or standing or lifting too much. Pregnant women often get hemorrhoids because of the strain from carrying the baby and from giving birth. 
No. There is no relationship between hemorrhoids and cancer. However, the symptoms of hemorrhoids can be similar to those of colorectal cancer and other diseases of the digestive system. Therefore, do not rely on over-the-counter medications or other self-treatments. See a colorectal surgeon first so your symptoms can be properly evaluated and effectively treated.
The following are tips for hemorrhoid prevention: Include more fiber in your diet. Fresh fruits, leafy vegetables, and whole-grain breads and cereals are good sources of fiber. Drink plenty of fluids. Eight glasses of water each day is ideal. Do not read on the toilet as this tends to promote sitting and straining which leads to swelling. Exercise regularly but avoid excessive lifting to the point of straining. Avoid laxatives that lead to loose and frequent stools and diarrhea.  This can be just as harmful to hemorrhoids as constipation.  Bulk-forming laxatives, such as Citrucel®, Metamucil®, Benefiber® as well as a daily stool softener such as Colace® or. When you feel the need to have a bowel movement, don’t wait for long periods before using the bathroom.
If you develop a hemorrhoidal flare-up or excessive pain, call to schedule an appointment right away to help prevent complications. We do our best to work you in right away with one of our specialists.  The following measures may help minimize your discomfort. • Take warm soaks three or four times a day and after every bowel movement. • Clean the anal area after each bowel movement by gently patting with moist toilet paper or moistened pads, such as baby wipes. Do not scrub the area or use soaps. • Use ice packs to relieve swelling. • Apply an over the counter hemorrhoid cream that contains witch hazel or similar brand to help lubricate before a bowel movement. • Avoid constipation by drinking up to 8 glasses of water a day, eating a diet high in fiber, adding a bulk fiber agent as well as a stool softener.