1. Once the anesthetic has been administered, the patient is made to lie flat with his legs spread apart and elevated on a stirrup. This is known as the lithotomy position.
2. The surgeon cleans the area with an antiseptic solution and puts on sterile drapes over the patient.
3. The surgeon inserts the proctoscope and takes a look at the piles and also does a digital examination under anesthesia before proceeding with the surgery.
4. The hemorrhoid is held with a forceps and pulled inwards. The pile is cut at its junction with the anal skin; it is then cut and freed away from the sphincter. Its blood vessel is then tied off with a stitch and the hemorrhoid is removed.
5. The same procedure is repeated for the other two pile masses.
6. The anal canal is packed with lubricated and medicated gauze.
7. A pad is placed over the area and a T-bandage is tied firmly.