What is THD hemorrhoid surgery?
THD (Transanal Hemorrhoidal Dearterialization) is a modern surgical method of treating hemorrhoids in which, instead of classic cutting and removal of hemorrhoidal tissue, the blood supply to the hemorrhoids is interrupted. Through a special instrument with an ultrasound (Doppler) probe the surgeon precisely locates the arteries that feed the hemorrhoids and ligates them, so the hemorrhoidal cushions gradually shrink and recede.
Hemorrhoids are dilated blood vessels (venous cushions) in the final part of the large intestine and around the anus, which are a normal part of the anatomy, but when they enlarge and become inflamed they cause bleeding, itching, pain and prolapse. Classic surgery (hemorrhoidectomy) means cutting and removing tissue, which is effective but accompanied by more pronounced pain and a longer recovery. The THD method resolves this problem differently — without an open wound.
Besides ligation of the arteries, THD often also includes mucopexy — suturing and lifting the prolapsed mucosa, which returns the hemorrhoidal cushions to their normal position and prevents their prolapse. The combination of these two procedures gives very good results, especially with second- and third-degree hemorrhoids.
At Medical Time THD is applied as a modern solution for patients who want effective treatment of hemorrhoids with as little pain as possible and a fast return to usual activities. Before the procedure a detailed examination is done that assesses the degree of the hemorrhoids and determines whether THD is the right method for the specific case.
When is THD surgery indicated?
THD is especially suitable for internal hemorrhoids of a medium degree, in which it gives excellent results with minimal discomfort. The decision on the method is made by the surgeon after an examination and assessment of the degree of the hemorrhoids, taking into account the symptoms and the treatment so far.
THD hemorrhoid surgery is recommended in the following situations:
- second- and third-degree hemorrhoids that bleed or prolapse
- repeated bleeding on emptying (bright red blood in the stool)
- hemorrhoids that prolapse with straining and then return or have to be pushed back by hand
- itching, moisture, a feeling of discomfort and incomplete emptying
- hemorrhoids that do not respond to medication, a change of diet and local therapy
- a wish for a method with less pain and faster recovery than classic surgery
- patients who want to avoid an open wound and a longer absence from daily activities
How THD surgery is performed
THD is performed using a special anoscope with a built-in ultrasound (Doppler) probe. The probe allows the surgeon to precisely hear and locate each artery that brings blood to the hemorrhoids. When an artery is located, the surgeon ligates it with a suture, thereby interrupting the blood supply — the hemorrhoidal cushion thus loses its source and gradually shrinks.
After ligation of the arteries, with hemorrhoids that prolapse a mucopexy is also done: the prolapsed mucosa with the hemorrhoidal tissue is lifted with a special suture and returned to its normal anatomical position. This prevents the cushions from prolapsing again and achieves a more lasting result.
The key advantage of the THD method is that the whole procedure takes place above the line that separates the sensitive part of the anal canal from the less sensitive one — so it is done in a zone without pronounced pain receptors. Because of this THD is considerably less painful than classic hemorrhoidectomy, there is no open wound that must heal for days, and recovery is faster.
Everything is done through the natural opening, without external incisions and without removing tissue by cutting. That is exactly why many patients experience THD as a considerably more comfortable option compared to traditional hemorrhoid surgery.
Preparation for THD surgery
Preparation for THD begins with an examination by the surgeon, who assesses the degree of the hemorrhoids and confirms that THD is the right method. If needed, to rule out other causes of bleeding, an endoscopic examination is also recommended (anoscopy, and in certain patients also a colonoscopy). Since the procedure is done under anesthesia, preoperative preparation is also carried out.
Before the procedure, preparation of the final part of the intestine is usually done (an enema or a mild laxative, according to the instructions), so the area is clean. The anesthesiologist assesses the form of anesthesia (most often spinal or short-term general), and the rules on fasting apply and accompaniment for the return home is arranged.
What is important to inform the surgeon of before the procedure:
- all medications you take, especially blood thinners
- chronic illnesses, previous surgeries and allergies
- your treatment of hemorrhoids so far and any earlier interventions
- bring earlier findings (anoscopy, colonoscopy) for review
- the rules on bowel preparation, fasting and arranged accompaniment
- all other symptoms on emptying, so other causes of bleeding can be ruled out
The procedure, anesthesia and duration
THD is most often performed under spinal or short-term general anesthesia, so the patient feels no pain during the procedure. The form of anesthesia is decided jointly by the surgeon and the anesthesiologist. The whole course takes place in the sterile conditions of the operating room, under anesthesiologist supervision.
After the anesthesia is introduced, the surgeon inserts the anoscope with the Doppler probe, locates the arteries that feed the hemorrhoids and ligates them with sutures. With hemorrhoids that prolapse a mucopexy is also done — lifting and returning the prolapsed mucosa to its normal position. There are no external incisions or removal of tissue by cutting, so there is no open wound either.
The procedure itself most often takes between 30 and 45 minutes, depending on the number of hemorrhoidal cushions and on whether a mucopexy is done. Throughout the procedure the anesthesiologist monitors the vital functions, so the procedure is safe and controlled.
After the procedure the patient recovers under the supervision of the staff. Thanks to there being no open wound, recovery is fast, and in the vast majority of cases the patient goes home the same day or with a short stay for observation, which the surgeon decides.
Recovery after THD surgery
One of the greatest advantages of the THD method is a fast and comfortable recovery. Since there is no open wound, the pain is considerably less than after classic hemorrhoid surgery, and most patients return to usual activities within a few days. In the first days a mild feeling of pressure, irritation or an urge to empty are possible, which gradually subside.
Tidy care and a soft stool are key to an easy recovery. A diet rich in fiber, enough fluids and, if needed, a mild stool softener are recommended, so that emptying is not straining. Lukewarm sitz baths help calm the area. Strenuous activities and lifting are postponed briefly, according to the surgeon's instructions.
What is recommended during recovery:
- take in enough fiber and fluids so that the stool is soft
- if needed use a mild stool softener according to the doctor's advice
- apply lukewarm sitz baths to calm the area
- avoid long sitting, straining on emptying and lifting in the first days
- maintain tidy hygiene of the area, gently and without aggressive rubbing
- contact the doctor if severe pain, heavier bleeding, swelling or a temperature appear
Risks and possible complications
THD is a safe and minimally invasive method, and serious complications are rare. Because it is done in a zone without pronounced pain receptors and without an open wound, the risks are lower than with classic hemorrhoidectomy. Still, as with any procedure, the patient is informed about the possible occurrences.
In the first days mild pain or a feeling of pressure, a transient urge to empty and minor bleeding are possible, which most often subside quickly. Rarely, heavier bleeding, transient difficulty with urination or a feeling of incomplete emptying can occur. With advanced hemorrhoids or with an insufficient change of habits there is a possibility that the symptoms partly return over time.
It is important to know that the long-term result also depends on the patient — maintaining a soft stool, an adequate intake of fiber and fluids and avoiding straining on emptying significantly reduce the risk of hemorrhoids reappearing. With a proper choice of method, an experienced technique and following the instructions, most risks are reduced to the lowest level.
Why have THD surgery done at Medical Time
At Medical Time THD hemorrhoid surgery is performed by an experienced surgical team, in modern hospital conditions and with constant anesthesiologist supervision. Before the procedure we assess the degree of the hemorrhoids in detail and choose the method that gives the best result with the least pain and the fastest recovery.
We attach special importance to the patient receiving an effective solution with as little discomfort as possible and a fast return to daily activities. After the procedure we stay with you for follow-ups and advice on diet and habits that reduce the recurrence of hemorrhoids.
- a modern, minimally invasive method without cutting and an open wound
- ultrasound (Doppler) guided ligation of the arteries for precision
- considerably less pain and faster recovery than classic surgery
- an experienced surgical team and constant anesthesiologist supervision
- modern, sterile hospital conditions and high safety standards
- as a rule a return home the same day and a fast return to activities
- advice on diet and habits for a lasting result, with a discreet approach
Price — THD hemorrhoid surgery
The price of THD hemorrhoid surgery depends on the number and degree of the hemorrhoidal cushions, on whether a mucopexy is done, as well as on the form of anesthesia. You get the exact price and an appointment after an examination and assessment, by calling or through the contact form.
- Surgeon's examination and assessment of the degree of the hemorrhoids
- THD hemorrhoid surgery (dearterialization)
- THD with mucopexy (lifting of the prolapsed mucosa)
For an individual estimate and an appointment, call 062-399-888.
Frequently asked questions about THD hemorrhoid surgery
With the THD method tissue is not cut or removed; instead, with ultrasound-guided ligation the blood supply to the hemorrhoids is interrupted, so the cushions recede. Since there is no open wound, THD is considerably less painful and accompanied by faster recovery than classic hemorrhoidectomy.
During the procedure you feel no pain, because it is done under anesthesia. Since the whole procedure takes place in a zone without pronounced pain receptors and without an open wound, the pain after the procedure is also considerably less than with classic surgery — most often it is a mild pressure that subsides quickly.
Recovery is fast. Most patients return to usual activities within a few days, and strenuous activities and lifting are postponed briefly, according to the surgeon's instructions. A tidy, soft stool further eases recovery.
THD gives excellent results with internal second- and third-degree hemorrhoids that bleed or prolapse. Whether THD is the right method for your case is assessed by the surgeon at the examination, according to the degree of the hemorrhoids and the symptoms.
THD gives a lasting result, but long-term success also depends on habits. A soft stool, enough fiber and fluids and avoiding straining on emptying significantly reduce the risk of hemorrhoids reappearing.
In the vast majority of cases this is a procedure after which you go home the same day or with a short stay for observation. The exact course is decided by the surgeon depending on the procedure and the form of anesthesia.
With bleeding on emptying it is important to rule out other causes, so in certain patients an anoscopy or colonoscopy is recommended before the procedure. Whether you need that examination is assessed by the surgeon based on your age, symptoms and findings.