Surgery for Treating Hemorrhoids

Surgery for removal of hemorrhoids will probably be advised if simple self-care treatments and home remedies do not yield satisfactory results. 
Surgery may be essential if your external hemorrhoids are very big and causing a lot of discomfort or if you have any small internal hemorrhoids. 
Often, untreated hemorrhoids could lead to hemorrhoidal flesh protruding out of the anus. This can cause severe pain, bleeding and discomfort. 
Common situations that necessitate surgical removal of hemorrhoids include prolapsed hemorrhoids, excessive bleeding, unbearable pain and thrombosed hemorrhoids.
Some fixative procedures are also forms of surgery and are included here for completeness. 

Types of Hemorrhoid Surgery 

Rubberband Ligation 

This is the most common, non-operative type of surgical removal of hemorrhoids. Rubberband ligation can be most effective on first and second-degree hemorrhoids.
In this technique, a rubber band, about one millimeter in diameter is fitted to a special gun-like device. The operator pulls the trigger, then the rubber band lodges itself at the base of the hemorrhoid, stopping the hemorrhoid’s blood supply.The hemorrhoid usually shrivels and falls out within a week. 
As a hemorrhoid does not have any nerve endings, the rubber band ligation procedure does not require anesthesia. 

Sclerotherapy 

This non-operative type of surgical removal of hemorrhoids involves the injection of a chemical solution all around the bleeding hemorrhoid or swollen blood vessels. The chemicals cause the blood vessels to shrink and fall off.
The inflammation then ceases when the hemorrhoid falls off. 

Infrared Coagulation: 

This non-operative type of surgical removal of hemorrhoids uses infrared radiation. The doctor has a special beam of infrared radiation fired at the hemorrhoids. The heat from the radiation causes the hemorrhoid to burn and fall out. 

Stapling 

This is a relatively new technique for the removal of hemorrhoids that is gaining popularity. But, there may be a greater chance of a relapse or recurrence of hemorrhoids when this technique is used. 

Hemorrhoidectomy 

This is an operation to remove hemorrhoids. This is fairly complicated and you need to be hospitalized.Normally, doctors prescribe this surgery only in cases of very severe hemorrhoids. The recovery period may also be long.
There are two types of Hemorrhoidectomy; a closed hemorrhoidectomy and a circular stapled hemorrhoidopexy. 
In a closed hemorrhoidectomy, the surgeon uses a special anal speculum to expose hemorrhoidal tissue. He then cuts off the tissue and closes the wound with absorbable stitches. 
In a circular stapled hemorrhoidopexy, the surgeon removes the excess mucosal tissue around the anal canal. The hemorrhoids are then pulled back and stapled. This procedure may be less painful and have a faster recovery period.

Cryosurgery 

This is another non-operative method for removal of hemorrhoids. Your doctor uses nitrous oxide or liquid nitrogen in a special device which is called a cryoprobe. The chemical helps to cool the tip of the cryoprobe near to freezing. 
The doctor uses this cold probe to either freeze hemorrhoids or ligate them. Either way, the hemorrhoids soon fall off. 
The surgery is painful, so doctors usually advise use of a local anesthetic.

Clot Removal 

This technique is for the surgical removal of clotted, or thrombosed, hemorrhoids. Your surgeon will have a local anesthetic administered. Then, the surgeon cuts off the skin, removes the clot, and then stitches the wound and applies a dressing. 
Although you are now free of the throbbing pain of the hemorrhoidal clot, you may feel lingering pain from the surgery for some time. This subsides as your wound heals. 
This technique may prove to be the best if done within four to five days of formation of the clot.

(The Complete Guide To Hemorrhoids)