What surgical procedures can be used to treat hemorrhoids?
Sometimes the symptoms of enlarged hemorrhoids are so bad that treating the symptoms alone is no longer enough. There are then various surgical treatment options.
Hemorrhoids are “cushions” of blood vessels and supporting tissue, found at the end of the rectum, just inside the anus. If they become enlarged, they can cause unpleasant symptoms. The decision of whether surgery is needed and, if so, which kind, will mainly depend on the size of the hemorrhoids and the severity of symptoms.
For grade 1 and grade 2 hemorrhoids, sclerotherapy and rubber band ligation ("banding") are considered first. These two treatments can also be combined.
If these procedures don't help enough, then the hemorrhoids need to be removed surgically. Doctors also often recommend surgery if someone has very enlarged grade 3 or grade 4 hemorrhoids that are sticking out. As well as conventional surgery to remove hemorrhoids (known as hemorrhoidectomy), there's a special surgical technique known as stapled hemorrhoidopexy or "stapling."
All of the approaches have their pros and cons. These are summarized in the following tables: