1. Stapled Haemarrhoidopexy -
Here the hemorrhoids are not removed, but the stretched out and expanded tissue that has allowed the hemorrhoids to prolapse downward is cut away. This pulls back the protruding hemorrhoids into the anal canal.
The supporting tissue high up in the anal canal is cut away in circular fashion and the ends are stapled together instead of using stitches.
The advantages of this procedure is that it is less painful and causes less bleeding, though it may at times lead to stricture formation, incontinence etc.
2.Transanal Hemorrhoidal Dearterialization (THD)
This procedure ties off the artery supplying the hemorrhoids, which leads to the pile mass eventually shriveling and falling off. It consists of an instrument called a Doppler to localize the blood supply, which has a special attachment to tie off the artery as well. This is done higher up in the rectum at the point where the blood vessel is given off, where the area is not sensitive to pain.
The advantage is in that it is not invasive, pain free and can be repeated even if the problem recurs. It is done as an outpatient procedure so that the patient can go home the same day and can resume normal activities from the next day. There is very little pain and bleeding after this method.