THD Procedure for Severe Hemorrhoids

What is Transanal Hemorrhoidal Dearterialization?

Transanal Hemorrhoidal Dearterialization (THD) is implemented for symptomatic internal hemorrhoids that fail conservative management. During this incisionless, minimally invasive procedure, the surgeon restricts the affected blood vessels with Doppler-guided technology and sutures. It is performed above the dentate line without the excision or “cutting” of tissue, so patients experience less pain and discomfort.

THD uses a doppler to locate the branches of the hemorrhoidal arteries that need to be terminated. Once the artery is located, the surgeon uses an absorbable suture to ligate or “tie-off” the arterial blood flow and the venous “out flow” remains to “shrink” the cushion. Each hemorrhoid requires four to six stitches, placed in precise locations to simply impede blood flow, without excising tissue.

When necessary, Dr. Kaufman at Huntington Colorectal will perform a hemorrhoidopexy to repair the prolapse. This repair restores and “lifts” the tissue back to its anatomical position. All processes within this procedure are done without the removal of any tissue.

Since there is no cutting or excision of tissue, patients experience less pain and a faster recovery time. People with severe hemorrhoids can be treated in one operation, unlike traditional surgery. Patients will leave the hospital the same day as their operation and since there are no open wounds, discomfort should only last four to five days.

Q: How do I know if my hemorrhoids are internal?

A: Internal hemorrhoids are found deep inside the rectum and oftentimes cannot be felt or seen. However, when these hemorrhoids enlarge and begin to protrude around the sphincter, it causes them to reach out of the anus. If you experience blood in your stool, a bulge or protrusion on your anus, or irritation and pain in the bulge, then contact Dr. Kaufman to schedule a consultation.

Q: What is a doppler?

A: The doppler is a probe that utilizes a double crystal, allowing more precise focusing of the ultrasound waves, which help surgeons locate all hemorrhoidal arteries during a THD procedure.

Q: How long does the THD procedure take?

A: The THD procedure typically takes less than hour, depending on the severity of the case, and is offered as an outpatient surgery. Patients will be released the same day as their surgery.

Q: What are the risks for the THD procedure?

A: Since this procedure is minimally non-invasive, the risk is very minimal. The most common complication is tenesmus, which can lead to rectal discomfort or pain. However, it is managed with analgesics and anti-inflammatory drugs and these symptoms rapidly disappear.

Please consult with Dr. Howard Kaufman to fully understand the pros and cons of the THD procedure.

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Treated Conditions

Hemorrhoid Removal
Pelvic Floor Disorders
Pelvic Floor
Fecal Incontinence
Anorectal Manometry
Anal Ultrasound
Obstructed Defecation
Rectal Prolapse

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Howard Kaufman, MD

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Address: 686 S Fair Oaks Avenue
Pasadena, CA 91105

Phone: (626) 397-5896
Fax: (626) 397-5899

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