Transanal Hemorrhoidal Dearterialization (THD)


After treating hemorrhoids for the past 10 years and being underwhelmed by the current therapies, I have recently been performing a newer procedure for the treatment of hemorrhoids. Patients have been quite happy with the results. The procedure is called Transanal Hemorrhoidal Dearterialization or THD.

THD uses a Doppler to locate the terminating branches of the hemorrhoidal arteries. Once the artery is located, a suture is used to ligate or “tie-off” the arterial blood flow. The venous “outflow” remains to “shrink” hemorrhoid. This is done without excision of tissue.

Step 1
THD uses a Doppler Ultra­sound, placed into the rectum, to locate the specific arteries which cause bleeding.

Step 2
Once the arteries have been located, the surgeon sutures the problematic artery(s) closed, resulting in an immediate reduction in swelling and bleeding. This is completed without cutting or removal of any tissue.

Step 3
Last, the surgeon will reposition any prolapsed or hanging tissue outside the anus to its natural anatomical position inside the anal canal with self-absorbing sutures.

If necessary a hemorrhoidopexy can be performed at the same time to repair a hemorrhoidal prolapse (hemorrhoid that is protruding from the anus). Again, this is done with suture and no excision of tissue. This repair restores and “lifts” the hemorrhoidal tissue back to its anatomical position.

The entire procedure is performed above the dentate line of the rectum so that there is minimal discomfort. The procedure takes about 30 minutes and is offered as an out-patient surgery.

In summary, THD is an excellent addition for the treatment of hemorrhoids. There is no cutting of tissue and the procedure offers patients a much quicker recovery when compared to a standard hemorrhoidectomy.

If you have requests, concerns, or require more information please feel free to contact me.

Benefits of Transanal Hemorrhoidal Dearterialization (THD) Procedure

  • Minimally Invasive
  • Return home same day.
  • Minimal discomfort
  • Back to work or normal activity in as few as 3 to 4 days, depending on the severity of disease
  • THD treats the source of Hemorrhoid disease, not the symptoms
  • No tissue is cut or excised
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