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Choosing the best method of haemorrhoids surgery for you

There are a variety of methods available to perform haemorrhoids surgery. Each method has its merits and shortcomings. Therefore, your surgeon should choose and tailor the procedure based on your unique presentation. What is written here is a summary of the various techniques currently practiced.
Conventional excisional haemorrhoidectomy
  • The prolapsed haemorrhoid is cut away and wound left open to heal spontaneously.
  • Oldest and most widely used technique.
  • Wound takes up to 4 weeks to heal and medication is given to reduce pain during bowel movement.
  • Longest healing time and most uncomfortable recovery among all techniques.
Closed-wound excisional haemorrhoidectomy
  • Similar to technique above except the wound is sutured together so that bowel movement is comfortable after surgery.
  • Not a good technique if if associated with large skin tags.
  • Only suitable for patients with single or dual haemorrhoids.
  • Recovery takes about 2 weeks but there is minimal pain during bowel movement.
Stapled haemorrhoidectomy
  • Prolapsed tissue is pulled back to ideal location before redundant tissue is excised. The cut edges are brought together by staples.
  • Less painful than excisional haemorrhoidectomy and painless during bowel movement.
  • Patients feel a persistent urge to have bowel movement for about 10 days after surgery.
  • BEST technique with lowest complication or recurrence rates.
  • For a short video on the technique, please visit the Ethicon website for an animation video of PPH surgery
Ligasure haemorrhoidectomy
  • Haemorrhoids are cut away with special instrument that cuts tissue and stops bleeding simultaneously.
  • May be less painful recovery than excisional haemorrhoidectomy but patients often complain of foul smelling discharge during the first 2 weeks after surgery.
  • For a short video on the technique, please visit the Ligasure website
Transanal Haemorrhoidal Dearterialization (THD)
  • A special ultrasound probe is used to identify the blood vessels to haemorrhoids which can be sutured.
  • This cuts off blood flow and the haemorrhoids will then shrink.
  • Least uncomfortable technique to treat haemorrhoids
  • Not suitable for prolapsed haemorrhoids as prolapsed tissue is not cut away.
  • For a short video on the technique, please visit the THD website
What is listed above is only a short description of the indication and contraindication for each technique. Please check with your surgeon on the potential complications and post-operative care necessary as there can be variations for each technique used.
If you have feedback or would like to know more about treatment for these conditions, feel free to contact us or make an appointment.