THD (Transanal Hemorrhoidal Dearterialization) in Dubai

THD may be recommended for patients with symptomatic internal hemorrhoids that cause:

• Rectal bleeding
• Prolapse (hemorrhoids that protrude during bowel movements)
• Discomfort, pain, itching, or irritation
• Recurrent symptoms despite dietary changes, medications, or office-based treatments

The operation works on the blood supply rather than on the haemorrhoidal tissue itself, which is what distinguishes it from excisional surgery.

1. Anaesthesia. General or regional anaesthesia, decided with the anaesthesiologist after your pre-operative assessment.
2. Locating the arteries. A specialised proctoscope with a Doppler probe is introduced. The probe detects the arterial branches feeding the haemorrhoidal cushions by their flow signal, so each is found rather than guessed at.
3. Ligation. Each identified artery is tied off with an absorbable stitch placed above the dentate line, in tissue that has no pain fibres. Loss of arterial inflow makes the cushions shrink over the following weeks.
4. Mucopexy. Where tissue has prolapsed, a continuous suture lifts it and fixes it back in its anatomical position. This part addresses the prolapse; the ligation addresses the bleeding.
5. End of procedure. Nothing is cut out and there is no open wound in the anal canal, which is the reason post-operative pain is generally lower than after a haemorrhoidectomy.

Patients go home the same day. ELEMENTAL is a DHA-licensed day surgical centre; you must be accompanied.

Who is a suitable candidate?

THD is generally suitable for adults with Grade II, III, or selected Grade IV internal hemorrhoids. Dr. Peter will assess your symptoms and medical history and will perform a physical examination with anoscopy to determine whether THD is the most appropriate treatment option for you.

• Minimally invasive procedure
• Much less postoperative pain compared with traditional hemorrhoid surgery
• No surgical wounds in the sensitive anal area
• Faster return to normal daily activities
• Effective treatment for bleeding and prolapsing hemorrhoids

Preparation is straightforward but a few points decide whether the operation goes ahead on the day.

• Medication. Bring a full list, including supplements. Anticoagulants and antiplatelet drugs such as warfarin, newer anticoagulants, aspirin and clopidogrel affect bleeding risk; any pause is agreed with the doctor who prescribed them, never decided by you or by us alone.
• Bowel preparation. Usually an enema on the morning of surgery rather than full bowel cleansing. You receive written instructions with the exact timing.
• Fasting. As instructed by the anaesthesiologist, typically six hours for food and two for clear fluids.
• Pre-operative tests. Blood tests and, depending on your age and history, an ECG. These are arranged together with the operation date so that results are ready for the anaesthesia review.
• On the day. Bring your Emirates ID and insurance documents if relevant, arrange an escort home, and plan not to drive for 24 hours after anaesthesia.
• Tell us in advance if you are pregnant or may be, have an active infection, or have had previous anal surgery — all three change the plan.

If your symptoms include bleeding that has not been investigated, a bowel examination may be advised before treating haemorrhoids: rectal bleeding is common with piles, but it is never assumed to come from them without assessment. See colonoscopy.

THD is a straightforward day-case procedure. Like any surgical procedure it has risks, and your surgeon explains them to you in full at the consultation, before you give consent.

Patients return home on the same day of surgery. Recovery recommendations typically include:

• Drink plenty of fluids and maintain a high‑fibre diet
• Use prescribed pain relief medications as directed
• Avoid straining during bowel movements
• Take stool softeners if recommended by your doctor
• Resume light activities as tolerated, usually within a few days
• Avoid heavy lifting and strenuous exercise for approximately 1–2 weeks, or as advised by your surgeon

At ELEMENTAL Day Surgical Center, we fully understand the sensitive nature of proctological conditions. Therefore, we have created a comfortable, private, and supportive environment for all patients seeking proctology care. Our clinic strictly adheres to all legal requirements and regulations set by the Dubai Health Authority (DHA), ensuring that every patient receives safe, compliant, and high‑quality medical attention.

At ELEMENTAL this treatment is carried out by Dr. Peter Lassu, Consultant General Surgeon (vascular and laparoscopic surgery).

Cost and your next step

THD, transanal haemorrhoidal dearterialisation — from AED 19,000 with intravenous sedation, or from AED 22,000 under general anaesthesia.

Whether THD is the right technique for your grade of haemorrhoids is decided after the examination, and the final figure is given to you in writing before anything is scheduled.