THD stands for Transanal Hemorrhoidal Dearterialization. It's a relatively new technique for treating symptomatic hemorrhoids without surgical cutting. Nationally, very few surgeons offer this form of treatment. THD works by tying off the main blood vessels that feed the hemorrhoids. Without blood supply, the hemorrhoids shrink up, and the symptoms they caused (such as bleeding, sliding in and out, or pain) will resolve. Patients with hemorrhoids are especially interested in THD because there's 'no cutting', and because it's well known that traditional hemorrhoids surgery is quite painful.
However, THD is not a 'painless' treatment for hemorrhoids, and it is still performed in the operating room. There's some discomfort, but probably from muscle spasm after the procedure, more than anything else. Bleeding is minimal, and in fact, Dr. Atallah, in a clinical study, has demonstrated that it can be safely performed for while patients are taking oral blood thinners for other, medical reasons, making THD a very important option for this subset of patients (read his study)
It's important for patients to understand that the type of treatment chosen for hemorrhoids varies from individual to individual. While some patients have an excellent response to dietary changes and a short course of suppositories, others may require office-based procedures such as rubber band ligation or other minor procedures that do not require anesthesia. More serious symptoms may require THD, while others benefit most from complete hemorrhoid excision. Below are photographs taken as Dr. Atallah performs THD. Essentially a small Doppler probe is used to target and ‘tie off’ the various arteries of the hemorrhoidal complex. The operation is quick and is almost always performed by Dr. Atallah in 30 minutes or less. (NEW!2018: Watch Dr. Atallah Discuss THD) (Watch more: video on THD)
