Over the past 20 years at HCA, we have helped thousands of patients avoid hemorrhoid surgery by the use of Rubber Band ligation of internal hemorrhoids. For the occasional patient whose office hemorrhoid treatment with banding is insufficient we now offer THD.

Transanal Hemorrhoidal Dearterialization (THD) is a minimally invasive procedure used to treat hemorrhoidal disease when ligation or topical treatments are insufficient, particularly for those who experience continued bleeding and excessive mucosal prolapse. THD involves the use of a Doppler ultrasound to locate and ligate the hemorrhoidal arteries in 4-6 locations, reducing blood flow to the hemorrhoids and allowing them to shrink. This technique is sphincter-sparing and does not involve tissue excision, which minimizes postoperative pain and preserves normal anal sphincter function. Studies report a success rate of 80-90%, with fewer complications such as pain and bleeding compared to traditional hemorrhoidectomy. However, some patients may experience recurrence or require additional treatments.

The recovery time for Transanal Hemorrhoidal Dearterialization (THD) is typically shorter than that of traditional hemorrhoidectomy, with most patients resuming normal activities within 1-2 weeks. Mild discomfort or pain may occur for a few days post-procedure, but it is generally manageable with over-the-counter pain relief. Since THD is a non-excisional procedure that spares tissue, patients experience less postoperative pain, quicker recovery, and minimal downtime compared to more invasive surgeries. However, individual recovery times may vary depending on the severity of the hemorrhoidal disease and the patient's overall health.

Transanal Hemorrhoidal Dearterialization (THD) and excisional hemorrhoidectomy are both effective treatments for hemorrhoidal disease, but they differ in approach, recovery, and complications. Excisional hemorrhoidectomy involves the surgical excision of hemorrhoids and is considered the gold standard for severe, prolapsed, or recurrent hemorrhoids. Although highly effective with lower recurrence rates, hemorrhoidectomy is more invasive, resulting in longer recovery times (up to 4-6 weeks), significant postoperative pain, and higher complication rates, such as infection or incontinence. Thus, THD is often preferred for less severe cases due to its minimal invasiveness, while hemorrhoidectomy is reserved for more severe, persistent cases.

Transanal Hemorrhoidal Dearterialization (THD) is typically covered by insurance in many countries, including the United States, when it is deemed medically necessary for the treatment of symptomatic hemorrhoidal disease. Coverage depends on the specific insurance plan, the severity of the condition, and whether more conservative treatments (e.g., topical medications, banding) have failed. It’s important for patients to check with their insurance provider to confirm coverage, pre-authorization requirements, and any out-of-pocket costs associated with the procedure.

Dr. Carmen Fong, is a Board Certified ColoRectal Surgeon At HCA Atlanta. Dr. Fong will review the options for hemorrhoid treatment with you. Her goal is to help heal your hemorrhoids while using the best treatments available.