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THD Doppler procedure for hemorrhoids: the surgical technique
1Department of Surgical Sciences, Catholic University, Largo A. Gemelli, 8, 00168, Rome, Italy, carloratto@tiscali.it.
Techniques in Coloproctology
|September 13, 2013
Summary
Transanal hemorrhoidal dearterialization (THD) effectively treats hemorrhoidal disease by reducing arterial flow and repositioning tissue. This safe and minimally invasive procedure offers long-term symptom resolution for most patients.
Area of Science:
- Colorectal Surgery
- Minimally Invasive Procedures
- Gastroenterology
Background:
- Hemorrhoidal disease affects a significant portion of the population.
- Traditional treatments may have limitations in efficacy and recovery.
- Transanal hemorrhoidal dearterialization (THD) offers a minimally invasive alternative.
Purpose of the Study:
- To illustrate the surgical technique of Transanal Hemorrhoidal Dearterialization (THD).
- To detail perioperative patient management for THD.
- To evaluate the efficacy and safety of THD for hemorrhoidal disease.
Main Methods:
- THD involves Doppler-guided ligation of hemorrhoidal arteries.
- Mucopexy is performed for prolapsing tissue using continuous sutures.
- The procedure is conducted under general or spinal anesthesia.
Main Results:
- THD leads to significant reduction in arterial overflow to hemorrhoidal piles.
- Long-term follow-up shows symptom resolution in the majority of patients.
- Transient tenesmus is the most common complication; serious complications are rare.
Conclusions:
- THD is a safe and effective treatment for hemorrhoidal disease when indicated.
- The procedure preserves anorectal physiology and anal sphincter function.
- THD offers a minimally invasive option with high patient satisfaction.
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