Last updated: 02/17/2009

There are several types of surgical procedures that can reduce hemorrhoids. Most surgical procedures in current use can be performed on an outpatient level or office visit under local anesthesia.

Rubber band ligation is a technique that works...

well with internal hemorrhoids that protrude outward with bowel movements. A small rubber band is tied over the hemorrhoid, which cuts off the blood supply. The hemorrhoid and the rubber band will fall off within a few days and the wound will usually heal in a period of one to two weeks. The procedure causes mild discomfort and bleeding. Another procedure, sclerotherapy, utilizes a chemical solution that is injected around the blood vessel to shrink the hemorrhoid. A third effective method is infrared coagulation, which uses a special device to shrink hemorrhoidal tissue by heating. Both injection and coagulation techniques can be effectively used to treat bleeding hemorrhoids that do not protrude. Some surgeons use a combination of rubber band ligation, sclerotherapy, and infrared coagulation; this combination has been reported to have a success rate of 90.5%.

Surgical resection (removal) of hemorrhoids is reserved for patients who do not respond to more conservative therapies and who have severe problems with external hemorrhoids or skin tags. Hemorrhoidectomies done with a laser do not appear to yield better results than those done with a scalpel. Both types of surgical resection can be performed with the patient under local anesthesia.