The evolving role of THD in hemorrhoids

Abstract THD® Doppler procedure is commonly utilized to manage hemorrhoidal disease. It has contributed to significant change in the therapeutic approach to this condition. Its purpose is to reduce the arterial overflow to the hemorrhoids by Doppler-guided dearterialization and reduction of hemorrhoidal prolapse by mucopexy. The dearterialization should be considered mandatory, while the mucopexy can be tailored according to the presence and grade of hemorrhoidal and mucosal prolapse. This procedure is overall safe, with minimal risk of life-threatening events or chronic complications, and low risk of recurrence. Postoperative management should allow a regular physiologic bowel movement, avoiding excessive trauma to the area of operation, and giving the best chance for a good long-term outcome.