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Hemorrhoid Surgery

Hemorrhoidectomy: Surgical Hemorrhoid Removal

Hemorrhoids are a prevalent condition that affect about 1 in 20 people in America. Also known as piles, hemorrhoids are inflamed veins inside or around the anus that can make everyday activities uncomfortable. Because hemorrhoids are so common and the symptoms are so unpleasant, there are many treatment options for addressing them.

A hemorrhoidectomy is a surgical procedure that your doctor may recommend to get rid of hemorrhoids. If your doctor has suggested a hemorrhoidectomy, it is a good idea to learn all that you can about it ahead of time so you can be comfortable with what to expect from both the procedure and the recovery.

To help you understand what a hemorrhoidectomy involves more clearly, this article covers what the procedure entails, who may need the treatment, and what to expect after hemorrhoidectomy surgery. Keep reading to become better educated about your hemorrhoid treatment choices.

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What Is a Hemorrhoidectomy?

A hemorrhoidectomy is a medical procedure that treats severe cases of hemorrhoids with surgical removal. Hemorrhoid surgery is one of the most effective forms of treatment for hemorrhoids that are particularly painful and unresponsive to less invasive methods of therapy. 

The purpose of a hemorrhoidectomy is to make a hemorrhoid shrink or disappear, which can be accomplished through a variety of techniques.

The following are the main types of surgical procedures used to remove hemorrhoids:

Conventional Surgical
Stapled Hemorrhoidectomy (PPH)
Harmonic Scalpel
Laser Removal
person laying in a hospital bed

Conventional Surgical

Although a conventional hemorrhoidectomy surgery is one of the most involved and invasive ways to address hemorrhoids, it is an extremely effective way to remove severe hemorrhoids. During the procedure, the hemorrhoidal tissue is clamped, tied off and cut away while the patient is under anesthesia. After the hemorrhoids have been successfully removed, the wound is sutured and an antibiotic ointment and gauze are applied.

This procedure can result in more pain and recovery time than other hemorrhoidectomy methods and may result in a short hospital stay in some cases.

Due to the invasive nature of surgery, there is also a higher risk of complications such as bleeding, pain and urinary retention with this treatment method

doctor consulting patient

Stapled Hemorrhoidectomy (PPH)

A stapled hemorrhoidectomy or procedure for prolapse and hemorrhoids (PPH) is typically used to treat internal hemorrhoids and involves a special stapling device that cuts through the affected vessels and staples the damaged tissue back together. By cutting off the blood flow to the hemorrhoids, the surgeon essentially staples the veins shut.

Because this technique usually comes with less pain than conventional hemorrhoidectomy surgery, it is growing in popularity among surgeons. However, this approach requires a significant recovery time and may come with more complications such as enlarged hemorrhoids.

patient explaining their symptoms to a doctor

Harmonic Scalpel

This hemorrhoid removal procedure relies on ultrasound waves and a special scalpel to cut away hemorrhoids and seal off some of the associated blood vessels. This method is less invasive than others and may reduce the amount of bleeding that occurs during hemorrhoid removal. For this reason, harmonic scalpel removal is typically used to remove large hemorrhoids or in situations when the removal needs to be as bloodless as possible.

The pain and recovery time for this technique tend to be slightly less than other hemorrhoid surgical options, with a somewhat lower risk of complications.

doctor talking to a patient about internal hemorrhoids

Laser Removal

For patients looking for a less invasive treatment option, laser removal is an effective hemorrhoidectomy procedure that uses a laser beam to remove the affected hemorrhoidal tissue. By generating an intense amount of heat, the laser beam cauterizes the blood vessels and seals off the vein so the hemorrhoid simply falls off.

A laser hemorrhoidectomy is nearly bloodless and most often performed in an outpatient procedure. Additionally, laser removal typically comes with a bit less pain than a conventional hemorrhoidectomy.

doctor talking to a patient about treatment


This relatively new surgical procedure for hemorrhoids involves blasting the hemorrhoid into very small pieces. After the atomization tool has broken the hemorrhoid into tiny pieces, a small vacuum sucks up the tissue and removes the pieces from the body. In general, surgery cures hemorrhoids, with only an average of five out of 100 people who have undergone hemorrhoid surgery needing further treatment. Along with this low recurrence rate, hemorrhoid surgery has a fairly low complication rate. Bleeding, pain and temporary inability to urinate due to swelling are the most common side effects.

While hemorrhoidectomy is a valid treatment in many circumstances, confirm with your doctor that you do indeed require surgery as 99% of patients can avoid surgery.

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Who May Need a Hemorrhoidectomy?

Typically, a hemorrhoidectomy is reserved for only the most severe cases of hemorrhoids. Because hemorrhoidectomy surgery is quite invasive, the procedure tends to be viewed as a last resort for hemorrhoid treatment. A hemorrhoidectomy might be recommended for those who continue experiencing hemorrhoid symptoms despite trying other methods of therapy, such as dietary changes.

While most people with hemorrhoids do not require a hemorrhoidectomy, the surgical procedure might be right for you if less invasive measures have not worked. 

Other reasons to get a hemorrhoidectomy include:

  • Extremely severe cases of hemorrhoids that cause a lot of intense discomfort
  • Internal hemorrhoids that are strangulated — trapped inside the anal muscles
  • External hemorrhoids that are swollen because of a blood clot
  • The presence of both external and internal hemorrhoids
  • Surgery is already needed for a different anorectal condition

Additional factors such as overall health, age and recovery outlook following surgery should also be taken into account when considering a hemorrhoidectomy. Be sure to consider the many nonsurgical hemorrhoid remedies available to you before resorting to a hemorrhoidectomy.

What to Expect from Hemorrhoidectomy

Knowing what to expect from a hemorrhoidectomy can help patients feel better prepared and more at ease about the procedure. Below is what you can anticipate during hemorrhoidectomy surgery as well as what the recovery period typically looks like.

During Treatment

A hemorrhoidectomy occurs at a hospital and is usually an outpatient procedure, although some cases may involve an overnight stay. Depending on what your doctor recommends, you will receive either general anesthesia or local anesthesia before the surgery. You will also have an IV put in to deliver medications that prevent infection, bleeding and swelling.

After you’ve gone under anesthesia, the surgeon will examine the internal hemorrhoids more closely by inserting a scope into the anal canal. Once they’ve gotten a better look at the affected tissues, they will use a scalpel or laser to cut the hemorrhoidal tissue off. Finally, the wound will be closed with dissolvable sutures.

Because you receive anesthesia for the procedure, a hemorrhoidectomy usually is not significantly painful. However, the affected area may hurt for a few weeks post-surgery, and your doctor may prescribe pain medication.


Completely recovering from hemorrhoidectomy surgery typically takes two to three weeks. During this time, you should try to eat a bland diet, such as plain rice, crackers, toast and applesauce, and drink plenty of liquids. Sticking to these guidelines and limiting your fiber intake will make bowel movements less painful.

Even if you follow post-care instructions, you might still experience some side effects post-surgery. These are the five most common complications after a hemorrhoidectomy:

  • Bleeding: Bleeding or a build-up of blood in the surgical area
  • Pain: Discomfort or soreness around the surgical area
  • Urinary retention: Inability to urinate
  • Incontinence: Inability to control the bladder or bowel, which may include discharge
  • Fecal impaction: Stool getting trapped within the anal canal and constipation

Although major concerns after a hemorrhoidectomy are rare, there is a chance of more serious symptoms, such as narrowing of the anal canal, an abnormal passage forming between the anal canal and a different area or a rectal prolapse, which occurs when the rectal lining slips outside of the anal opening. Contact your physician if you experience any of these issues.

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