THD Doppler: A Reliable Surgical Procedure to Treat Hemorrhoids

Gachabayov M., Angelos G., Bergamaschi R.
Surg Technol Int. 2019 Mar 18; 34. pii: sti34/1088.

The search for alternatives to excisional surgery for internal hemorrhoids has been motivated by a desire to reduce postoperative pain and its associated disability as well as chronic sequelae. Among several nonexcisional procedures, Doppler-guided transanal hemorrhoidal dearterialization (THD Doppler) has emerged as an alternative that offers minimal postoperative pain. However, there is some skepticism regarding the ligation of hemorrhoidal arteries, the usefulness of Doppler guidance, and the recurrence rates after THD Doppler. The aim of this narrative review is to compare THD to both non-excisional alternatives, such as rubber band ligation and stapled hemorrhoidopexy, and excisional alternatives, such as Ferguson hemorrhoidectomy. The authors seek to give readers concise insight into the evidence available in the English literature. This report does not offer a quantitative synthesis of the data, but rather highlights the role of THD Doppler in the treatment of internal hemorrhoids.