Transanal Hemorrhoidal Dearterialization Steps

The THD procedure is performed in a series of carefully orchestrated steps to ensure precision and effectiveness:

1. Preoperative Preparation
   Before the procedure, patients undergo a thorough medical evaluation to determine their suitability for THD. This includes a detailed medical history, physical examination, and sometimes imaging studies. Patients are also advised to follow specific preoperative instructions, such as fasting for a certain period before surgery.
2. Anesthesia
   The procedure is typically performed under local anesthesia with sedation or general anesthesia, depending on the patient’s condition and preferences. This ensures that the patient remains comfortable and pain-free during the surgery.
3. Doppler Ultrasound Localization
   A Doppler ultrasound device is used to locate the arteries supplying blood to the hemorrhoids. This device emits sound waves that help the surgeon identify the precise location of the arterial branches.
4. Ligation of Hemorrhoidal Arteries
   Once the arteries are located, the surgeon uses a special suture material to ligate (tie off) these arteries. This step effectively reduces the blood flow to the hemorrhoids, causing them to shrink over time.
5. Mucosectomy (Optional)
   In some cases, a small amount of excess mucosal tissue may be removed (mucosectomy) to enhance the effectiveness of the procedure. This step is usually performed when there is significant prolapse of the hemorrhoidal tissue.
6. Completion and Recovery
   After the ligation is complete, the procedure is concluded, and the patient is monitored for a short period before being discharged. Most patients can go home the same day, with instructions on postoperative care and follow-up appointments.