Hemorrhoidectomy

• Definitive and permanent solution – Hemorrhoidectomy completely removes hemorrhoidal tissue, providing the lowest recurrence rate among all treatment options. While laser therapy or banding may require repeat sessions, excisional surgery offers durable, long-lasting results especially for advanced grades of hemorrhoids
• Highly effective for advanced hemorrhoids – Hemorrhoidectomy is the treatment of choice for grade IV (permanently prolapsed and irreducible), large external hemorrhoids, thrombosed hemorrhoids (clotted veins causing severe pain), and mixed hemorrhoids that involve both internal and external components. Unlike less invasive methods that are ineffective for these advanced stages, hemorrhoidectomy directly addresses and removes the problem tissue
• Single-session treatment – All affected hemorrhoids are removed in a single procedure under appropriate anaesthesia, eliminating the need for multiple office visits or repeat interventions
• DHA-licensed, modern day surgical facility – Your hemorrhoidectomy is performed in our fully accredited DHA day surgical center, equipped with modern operating rooms, advanced anaesthesia monitoring, and sterile surgical instrumentation

You may be a candidate for hemorrhoidectomy if you experience:

• large grade IV internal hemorrhoids – which cannot be reduced at all (grade IV), often accompanied by persistent bleeding, discomfort, and hygiene difficulties
• Large external hemorrhoids – painful, swollen veins under the skin around the anus that interfere with sitting, walking, or daily activities
• Thrombosed external hemorrhoids – sudden, severe pain caused by a clot within the hemorrhoid, often accompanied by a firm, blue‑purple lump. If symptoms persist beyond 72 hours or the pain is intolerable, surgical excision provides immediate relief
• Failed minimally invasive treatments – when rubber band ligation, sclerotherapy, laser therapy or THD has failed to control symptoms or when hemorrhoids recur after these procedures
• Strangulated hemorrhoids – a surgical emergency where the prolapsed hemorrhoid becomes trapped and its blood supply is cut off. This condition requires urgent surgical intervention to prevent tissue necrosis and gangrene

• Patients with grade I‑II -III hemorrhoids that are well‑managed with conservative therapy (dietary changes, fibre, hydration) or office‑based procedures (banding, Laser, THD)
• Patients with significant comorbidities (severe heart, lung, or kidney disease) that make surgery or anaesthesia unsafe. These patients may be referred for alternative management
• Patients with active perianal infections or sepsis
• Patients who are pregnant

Before Surgery (Pre‑Operative Preparation)

• Pre‑operative consultation – Dr. Lassu will take a detailed medical history, perform a physical examination and anoscopy, and review any previous treatments. If indicated, a colonoscopy may be arranged to rule out other colorectal pathology, especially if you have not had a recent one or have risk factors for colorectal cancer
• Medication adjustments – You may need to stop blood‑thinning medications (aspirin, warfarin, clopidogrel, apixaban, ibuprofen, naproxen) for a specified period before surgery as instructed. Inform Dr. Lassu of all medications you take
• Bowel preparation is not included  in dr Peter Lassu's protocol
• Fasting – No food or drink for 6‑8 hours before the procedure, as required for anaesthesia
• Arrange transportation – You will need a responsible adult to drive you home, as sedation or anaesthesia affects your ability to drive

During Surgery (Day Surgery – Typically 20-50minutes)

• Anaesthesia – The procedure is performed under spinal anaesthesia (numbing the lower body while you remain awake but sedated) or general anaesthesia (you are completely asleep). Dr. Lassu will discuss the best option for you
• Positioning – You will be placed in the lithotomy position (lying on your back with legs elevated in stirrups) to allow optimal surgical access
• Procedure – Dr. Lassu will remove the hemorrhoidal tissue with a closed technique, so there is no open wound remains, which will make recovery much more comfortable.
• Recovery area – You will be monitored in the recovery suite for 2‑4 hours before discharge

After Surgery – Recovery and Post‑Operative Care

Pain is expected after hemorrhoidectomy – the procedure involves an incision in a highly innervated area, so post‑operative pain is normal. With proper management, most patients find the pain tolerable and notice significant relief after the first few days. Your recovery is supported by a comprehensive aftercare plan and direct access to Dr. Lassu during the healing period.

Days 1‑3 (Immediate Post‑Operative Phase):

• Pain management – Severe pain is common during the first 48‑72 hours. Dr. Lassu will prescribe appropriate oral analgesics. 
• Sitz baths – Take warm sitz baths 3‑4 times daily and after each bowel movement to reduce inflammation, soothe the wound, and promote healing
• Bowel care – Start a stool softener (e.g., docusate sodium) on the day of surgery to prevent constipation. Drink 2‑3 litres of water daily and eat a high‑fibre diet (fruits, vegetables, whole grains)
• Bleeding – Some bleeding is normal, especially during the first bowel movement. Use a sanitary pad or gauze pad to absorb any drainage, and change it frequently
• Activity – Rest with minimal movement. Avoid sitting for prolonged periods; lie down or walk gently instead. Light walking is encouraged to improve circulation

Week 1 (Initial Healing Stage):

• Swelling and discomfort begin to subside. Continue sitz baths, stool softeners, and a high‑fibre diet. Avoid heavy lifting (more than 5‑10 kg) and strenuous activities. Many patients can resume light desk work after 5‑7 days
• If you experience severe pain despite medication, heavy bleeding (soaking more than one pad per hour), fever, chills, or inability to urinate, contact ELEMENTAL Day Surgical Center immediately

Weeks 2‑3 (Gradual Improvement):

• Most patients notice significant pain relief after the first week. Bowel movements become more regular. Continue a high‑fibre diet and hydration. A follow‑up consultation will be scheduled with Dr. Lassu to assess healing. 

Weeks 4‑6 (Full Recovery):

• Internal healing continues; minor sensitivity may persist but is not incapacitating. Regular activities including exercise, long sitting, and travel can be resumed. Lifelong adherence to a high‑fibre diet, adequate hydration, and avoiding straining will reduce the risk of new hemorrhoids developing in other anal cushions

Hemorrhoidectomy is the most effective treatment for advanced hemorrhoids with the lowest recurrence rate of any modality. However, new hemorrhoids may form in other anal cushions if the underlying causes (chronic constipation, prolonged straining on the toilet, heavy lifting, pregnancy, chronic diarrhoea) are not addressed.

Dr. Lassu will provide detailed lifestyle and dietary advice to help you maintain your results and prevent future problems.

You do not have to continue living with the chronic pain, bleeding, prolapse, and embarrassment caused by advanced hemorrhoids. Hemorrhoidectomy is a safe, effective, and definitive treatmentthat can restore your quality of life. If you have grade IV hemorrhoids, large external hemorrhoids, thrombosed hemorrhoids, or have failed previous treatments, Dr. Peter Lassu at ELEMENTAL Day Surgical Center is here to help.