Hemorrhoids, swollen veins in the rectum and anus, are a common but often distressing condition affecting millions of adults worldwide. While conservative treatments such as dietary adjustments, topical medications, and lifestyle changes work for many, some cases require surgical intervention. Fortunately, modern advancements have transformed the surgical landscape, making hemorrhoid procedures less invasive, painful, and effective. This article explores the latest minimally invasive hemorrhoid surgery technologies and how they change patient experiences and outcomes.
Understanding Hemorrhoids and When Surgery Becomes Necessary
Hemorrhoids can be internal or external and range in severity. Mild symptoms may include itching, discomfort, and minor bleeding, while advanced hemorrhoids can cause intense pain, prolapse, and chronic bleeding.
When non-surgical treatments fail or when complications like thrombosis or prolapse occur, surgery becomes the most viable solution. Traditional surgical techniques, like excisional hemorrhoidectomy, though effective, often involve significant pain, a more extended recovery period, and a higher risk of complications. That’s why the rise of minimally invasive procedures is a welcome development, offering quicker healing with less discomfort.
Doppler-Guided Hemorrhoidal Artery Ligation (DGHAL): Targeting the Source
One of the groundbreaking technologies in minimally invasive hemorrhoid treatment is Doppler-Guided
Hemorrhoidal Artery Ligation (DGHAL), also known as transanal hemorrhoidal dearterialization (THD).
This procedure uses a small ultrasound probe to locate the arteries supplying blood to the hemorrhoids. Once detected, these arteries are tied off (ligated) with sutures, reducing blood flow and causing the hemorrhoids to shrink. Since it addresses the root cause—excessive blood supply—this method is highly effective for internal hemorrhoids.
DGHAL is performed without incisions and typically results in less postoperative pain, fewer complications, and a faster return to normal activities compared to traditional surgery. Most patients can resume regular routines within a few days, making it ideal for those seeking minimal disruption to daily life.
Laser Hemorrhoidoplasty (LHP): Precision with Minimal Tissue Damage
Laser Hemorrhoidoplasty is a minimally invasive procedure that uses a precise laser fiber to shrink hemorrhoidal tissue. The laser energy is delivered directly into the hemorrhoid through a small probe, causing it to coagulate and retract without cutting or removing tissue.
This technique results in minimal bleeding, minimal postoperative discomfort, and a reduced risk of infection. LHP is typically performed outpatient, allowing patients to recover faster with less reliance on pain medications.
Laser technology also offers unparalleled precision, targeting only the affected tissue while preserving surrounding healthy structures. This not only improves cosmetic outcomes but also reduces the chance of long-term complications like anal stenosis or incontinence.
Stapled Hemorrhoidopexy (PPH): A Game-Changer for Prolapsed Hemorrhoids
For patients suffering from prolapsed internal hemorrhoids, the Procedure for Prolapse and Hemorrhoids (PPH), commonly known as stapled hemorrhoidopexy, offers a highly effective and minimally invasive option.
This procedure involves repositioning the hemorrhoids back into their normal anatomical position and stapling the tissue to cut off the blood supply. Unlike traditional hemorrhoidectomy, which removes tissue, stapled hemorrhoidopexy avoids large incisions and nerve endings, resulting in significantly less pain.
Patients undergoing PPH generally experience shorter recovery times and quicker returns to work or normal activities. While it’s highly effective for treating prolapsed hemorrhoids, it may not be suitable for external hemorrhoids, making patient selection critical.
Radiofrequency Ablation (RFA): High-Frequency Relief
Radiofrequency Ablation is a newer technique gaining popularity in the minimally invasive treatment of hemorrhoids. It uses high-frequency radio waves to generate heat that targets and shrinks hemorrhoidal tissue.
The precision of RFA ensures that only the affected veins are treated, minimizing damage to surrounding healthy tissue. This approach reduces inflammation, improves blood flow, and accelerates healing.
RFA is typically done as an outpatient procedure under local anesthesia. It offers several benefits, including:
Minimal discomfort
No cutting or suturing
Faster healing
Excellent cosmetic results
As with other technologies, RFA works best for selected cases of internal hemorrhoids and is increasingly favored in outpatient proctology settings.
Infrared Coagulation (IRC): Fast and Non-Surgical
Infrared Coagulation is another non-surgical method that uses infrared light to generate heat and coagulate the hemorrhoidal blood vessels. It’s typically used for first- and second-degree internal hemorrhoids.
The procedure is quick, lasting only a few minutes, and is done in a physician’s office without anesthesia. Patients may feel slight discomfort during the process, but it doesn’t involve cutting or tissue removal.
While IRC may require multiple sessions for optimal results, its low complication rate and convenience make it an appealing first-line intervention for early-stage hemorrhoids.
Enhanced Imaging and Robotics: The Future of Hemorrhoid Surgery
Innovations in enhanced imaging, robotics, and artificial intelligence also make their mark in proctologic surgery. Robotic-assisted tools provide greater precision during hemorrhoid procedures, improving outcomes and reducing surgeon fatigue. High-definition cameras and 3D imaging give surgeons a more accurate view of the anorectal area, leading to safer and more efficient interventions.
AI-based systems are being developed to help predict recurrence risks and guide surgical decisions based on individual anatomy and symptom severity. These technologies promise a future of personalized, minimally invasive hemorrhoid treatment with even greater success rates.
Postoperative Care and Recovery: Quicker, Smoother, and Less Painful
One of the most significant benefits of minimally invasive hemorrhoid surgery is the recovery experience. Unlike traditional methods that could result in weeks of downtime, newer technologies often allow patients to return to regular routines within a few days.
Postoperative care typically involves:
Warm sitz baths for comfort
Over-the-counter pain relief
High-fiber diets and hydration to avoid straining
Avoiding heavy lifting or vigorous exercise for a short period
Because these modern procedures cause less trauma to tissue, patients experience lower infection rates, minimal bleeding, and fewer complications overall.
Technology Is Reshaping Hemorrhoid Care
Hemorrhoid surgery has come a long way. Today’s minimally invasive techniques are safer, faster, and more comfortable than ever before. From laser and radiofrequency tools to Doppler guidance and robotic assistance, patients can now access effective treatments with minimal disruption to their lives.
If you’ve been struggling with chronic or severe hemorrhoids, it’s worth discussing these advanced options with your healthcare provider. With the right technology and personalized care, lasting relief is not just possible—it’s within easy reach.