What are the Different Types of Hemorrhoid Surgery?

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  • Written By: Karyn Maier
  • Edited By: C. Wilborn
  • Last Modified Date: 15 October 2019
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Hemorrhoids, also known as piles, are inflamed veins of the anus and rectum. They may occur inside or outside of the rectum. Since the tissue affected by those occurring inside the rectum has few pain receptors, they often escape notice unless they become prolapsed and are displaced outside the rectum. External hemorrhoids, on the other hand, are usually quite painful and difficult to ignore. Fortunately, there are several types of hemorrhoid surgery options available to help put an end to inflammation and leave pain and discomfort behind.

Generally, most physicians recommend implementing dietary and lifestyle changes to address the problem before resorting to hemorrhoid surgery. If the patient’s condition does not respond to these efforts, however, or if there is a significant degree of prolapse and thrombosis, then it is likely that a hemorrhoidectomy will be considered. This procedure involves the surgical removal of the hemorrhoids by one of several methods. Which method used depends on several factors, such as the grade of the hemorrhoids in terms of size and location, the age of the patient, and any existing medical conditions that may pose additional risks.


The most frequently performed traditional hemorrhoid surgery is the open hemorrhoidectomy, also known as the Milligan–Morgan Technique. In this procedure, the hemorrhoid tissue is exposed with a retractor and then dissected. Three triangular-shaped incisions are made at the site and left open for the purpose of creating connecting bands of skin between them. Medical conditions considered a contraindication to this open surgery include cancer, Crohn’s disease, AIDS, and other immune deficiency disorders.

The Ferguson Technique is similar to the above method, but is a closed surgical procedure. In fact, each site is sutured completely with absorbable surgical thread. This procedure is not recommended for elderly patients and those with certain preexisting medical conditions. In addition, this type of surgery is usually reserved for third and fourth degree hemorrhoids, which are prolapsed, strangulated, or thrombosed.

A third type of hemorrhoidectomy is known as the Whitehead Technique. This procedure involves the total removal of hemorrhoids by removing the rectal tissue in which they reside. This procedure, which originated in the late 1800s, is rarely performed today due to the risk of stenosis, or the narrowing of the anal canal.

Newer and less invasive procedures to address hemorrhoids pose fewer complications, improve recovery time, require less pain medication, and are highly effective. For example, laser surgery pinpoints and targets nerves and blood vessels surrounding the hemorrhoid, in effect strangling off the supply of blood and oxygen. A beam of light then eradicates the hemorrhoid with exact precision and without any causing excess bleeding at the site.

A relatively new type of hemorrhoid surgery is called atomizing. In this procedure, the hemorrhoid is exposed to an electrical current that vaporizes each layer of cells. The hemorrhoid tissue is completely converted into a mist of fine particles that are simply vacuumed away.


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