THD (Transanal Hemorrhoidal Dearterialization)

What Is THD?

THD (Transanal Hemorrhoidal Dearterialization) is a modern, tissue-preserving surgical technique used in the treatment of hemorrhoidal disease. It is a non-excisional and incision-free method in which the arteries supplying the hemorrhoids are identified using Doppler ultrasound and ligated, reducing blood flow and allowing the hemorrhoids to shrink.

How Is THD Performed?

THD is usually performed under spinal or general anesthesia. Using a specially designed Doppler-guided anoscope, the hemorrhoidal arteries are detected and ligated with absorbable sutures. If prolapse is present, a mucopexy (hemorrhoidopexy) can be performed during the same procedure. The operation typically lasts 30–45 minutes.

Who Is a Suitable Candidate?

• Patients with grade 2, 3, and selected grade 4 internal hemorrhoids

• Individuals with bleeding or prolapsing hemorrhoids

• Patients seeking an alternative to conventional hemorrhoidectomy

Advantages

• No tissue excision or incision

• Less postoperative pain

• Preservation of anal anatomy

• Short hospital stay

• Rapid return to daily activities

Possible Risks and Side Effects

Temporary anal pain, a feeling of fullness, or mild bleeding may occur after THD. Rarely, thrombosed hemorrhoids, infection, or recurrence can develop. Complication rates are low when performed by experienced surgeons.

Recovery Process

Most patients can return to normal daily activities within 1–2 days. A high-fiber diet and adequate fluid intake support the healing process.