A hemorrhoidectomy is a specialized surgical procedure that involves removing or reducing symptomatic hemorrhoids—swollen vascular cushions in the lower rectum and anus. At our practice, we understand that hemorrhoid issues can be both physically uncomfortable and emotionally distressing to discuss. That's why we're committed to providing compassionate, expert care while helping you understand each step of your path of treatment.
This targeted procedure effectively treats hemorrhoids that have not responded to conservative management, cause recurrent bleeding, pain, or hygiene difficulties, or have become thrombosed (clotted) or significantly prolapsed (protruding). Our hemorrhoid treatment approach utilizes several advanced techniques including traditional excision, laser therapy, rubber band ligation, stapling procedures, and ligature methods. We carefully select the most appropriate approach based on your specific hemorrhoid type, location, severity, and individual health factors. Our comprehensive approach includes both surgical expertise and detailed post-procedure care guidance, resulting in effective, lasting relief from hemorrhoid symptoms while prioritizing your comfort and quick return to normal activities.
You may need a hemorrhoidectomy if you experience:
Recurrent or persistent bleeding during bowel movements
Pain or significant discomfort from external hemorrhoids
Prolapsed internal hemorrhoids that cannot be manually reduced
Thrombosed (clotted) hemorrhoids causing severe pain
Large external hemorrhoids causing hygiene difficulties
Anemia resulting from chronic hemorrhoidal bleeding
Hemorrhoids causing persistent itching or irritation
Failed conservative treatments including dietary changes and topical medications
Mixed hemorrhoids (both internal and external) causing multiple symptoms
Recurrence after previous hemorrhoid treatments
Significant discomfort affecting daily activities or quality of life
Chronic mucus discharge from prolapsed hemorrhoids
Difficulty with bowel movements due to hemorrhoidal tissue
Fecal leakage associated with enlarged hemorrhoids
Hemorrhoids causing painful intercourse or other intimate activities
At Lifetime Surgical, our approach to hemorrhoidectomy combines precision with personalized care. The procedure begins with a comprehensive evaluation of your specific hemorrhoid condition, including detailed examination to determine the type (internal, external, or mixed), grade (for internal hemorrhoids), location, and severity.
At our practice, we have expertise in multiple hemorrhoid treatment techniques, allowing us to select the optimal approach based on your unique situation:
Traditional Excisional Hemorrhoidectomy: For severe, large, or mixed hemorrhoids, we perform precise surgical excision using either the closed technique (removing hemorrhoids and closing the wound with absorbable sutures) or the open technique (removing hemorrhoids and leaving the wound partially open to heal gradually). This approach provides definitive treatment for the most severe cases, though it requires more recovery time than other methods. We utilize specialized pain management protocols to enhance comfort during the healing process.
Laser Hemorrhoidectomy: This advanced technique uses precisely targeted laser energy to remove hemorrhoidal tissue with minimal bleeding and exceptional precision. The laser simultaneously cuts and seals blood vessels, reducing post-operative pain and speeding recovery compared to traditional techniques. The focused energy allows for extremely precise tissue removal while preserving surrounding healthy tissue, making it particularly beneficial for patients with well-defined hemorrhoids seeking a less painful recovery. The reduced bleeding also provides excellent visualization during the procedure, allowing for meticulous technique with less trauma to surrounding tissue.
Rubber Band Ligation: For grade I to III internal hemorrhoids, we offer this minimally invasive office procedure that places small rubber bands around the base of internal hemorrhoids, cutting off their blood supply. The banded tissue and bands fall off within 1-2 weeks, leaving a small scar that prevents the hemorrhoid from protruding. This quick procedure requires no anesthesia and allows immediate return to activities, though it may require multiple sessions for complete treatment. The ideal candidates are patients with internal hemorrhoids that bleed or protrude but can be manually reduced.
Stapled Hemorrhoidopexy: Also known as PPH (Procedure for Prolapse and Hemorrhoids), this technique uses a specialized circular stapling device to remove a band of tissue above the hemorrhoids and staple the remaining tissue in place. This effectively lifts prolapsed tissue back to its natural position while interrupting blood flow to the hemorrhoids. Benefits include less post-operative pain and faster recovery than traditional hemorrhoidectomy, making it particularly useful for internal hemorrhoids with significant prolapse (grades III-IV) and minimal external components.
Hemorrhoidal Artery Ligation: This ultrasound-guided procedure precisely identifies and suture-ligates the arteries feeding the hemorrhoidal tissue, reducing blood flow and causing the hemorrhoids to shrink. Often combined with mucopexy (tissue fixation), this technique effectively addresses prolapsing internal hemorrhoids while causing minimal post-procedure pain. This approach is excellent for patients with bleeding internal hemorrhoids and moderate prolapse who want to avoid the more extensive recovery of excisional techniques.
Throughout your care journey, we provide comprehensive education about post-procedure expectations and detailed instructions for optimal healing. Our multidisciplinary approach ensures that underlying contributors to hemorrhoid development, such as constipation or dietary factors, are addressed alongside the surgical intervention to minimize recurrence risk and promote long-term relief.
Immediate Post-Procedure (1-3 days)
For Traditional Excisional Hemorrhoidectomy:
Receive specialized pain management including local anesthetics and prescribed medications
Begin sitz baths (warm water soaks) within 24 hours, continuing several times daily
Take stool softeners as prescribed to avoid constipation
Expect some bleeding with bowel movements, typically minimal
Apply prescribed topical treatments as directed
Maintain good hygiene with gentle cleansing after bowel movements
Use ice packs intermittently for comfort during the first 48 hours
Manage pain with prescribed medications taken on schedule
For Laser Hemorrhoidectomy:
Experience less post-operative pain compared to traditional techniques
Begin sitz baths within 24 hours as directed
Take pain medication as needed, typically requiring lower doses
Follow the same hygiene and stool softener regimen as traditional methods
Notice reduced bleeding due to the sealing effect of the laser
Maintain activity restrictions similar to traditional approaches
For Rubber Band Ligation:
Experience pressure or mild discomfort for 24-48 hours
Avoid strenuous activities for 24 hours
Take over-the-counter pain relief if needed
Expect to return to normal activities immediately
Monitor for excessive bleeding, which is rare
Continue normal bowel habits with attention to avoiding constipation
For Stapled Hemorrhoidopexy:
Experience less pain than with traditional excisional techniques
May notice minor bleeding with initial bowel movements
Follow instructions for sitz baths and hygiene
Take prescribed medications for comfort
Begin walking soon after the procedure to promote circulation
Monitor for urinary retention, which can occasionally occur
For Hemorrhoidal Artery Ligation:
Experience minimal post-procedure pain, typically manageable with over-the-counter medication
Resume normal activities within 1-2 days
Follow instructions for avoiding constipation
Expect minimal bleeding or discharge
Monitor for urinary retention, particularly in male patients
Short-Term Recovery (1-2 weeks)
For Traditional Excisional Hemorrhoidectomy:
Attend your follow-up appointment (typically 7-10 days after surgery)
Continue sitz baths after bowel movements and several times daily
Maintain a high-fiber diet and adequate fluid intake
Avoid heavy lifting or strenuous activities for 2 weeks
Monitor for proper wound healing and report any concerns
Expect ongoing mild discomfort, gradually improving
The first bowel movement may be uncomfortable; maintain stool softeners
Return to work based on your surgeon's recommendation and job requirements (typically 7-14 days)
For Laser Hemorrhoidectomy:
Experience faster healing compared to traditional techniques
Continue sitz baths and hygiene measures
Return to work typically within 3-7 days
Notice progressive improvement in comfort levels
Begin transitioning from pain medication to over-the-counter options
Follow dietary recommendations to maintain soft bowel movements
Resume light exercise after 1 week if comfortable
For Rubber Band Ligation:
Band and hemorrhoid typically fall off within 5-7 days
Notice reduction in hemorrhoid symptoms after the banded tissue falls off
Maintain normal activities throughout the process
May require subsequent banding sessions for additional hemorrhoids
Monitor for rare delayed bleeding when the band falls off
Continue high-fiber diet and hydration
For Stapled Hemorrhoidopexy:
Return to normal activities sooner than with traditional hemorrhoidectomy (typically 7-10 days)
Monitor for proper healing at your follow-up appointment
Continue dietary measures to prevent constipation
Expect minimal external wound care requirements
Resume most normal activities within 1-2 weeks
Notice continued improvement in initial symptoms
For Hemorrhoidal Artery Ligation:
Expect near-complete recovery within 7 days
Continue measures to prevent constipation
Notice gradual shrinking of hemorrhoidal tissue as circulation decreases
Monitor for proper healing at the follow-up appointment
Resume all normal activities within 1 week
Long-Term Recovery (3-6 weeks)
For Traditional Excisional Hemorrhoidectomy:
Complete wound healing typically occurs within 4-6 weeks
Resume all normal activities including exercise by 3-4 weeks
Notice continued improvement in comfort and function
Maintain dietary and lifestyle changes to prevent recurrence
Occasional mild discomfort may persist during final healing
Follow up with your surgeon to confirm complete healing
Begin implementing long-term strategies to prevent hemorrhoid recurrence
For Laser Hemorrhoidectomy:
Experience complete healing typically within 3-4 weeks
Resume all normal activities including exercise by 2-3 weeks
Notice minimal scarring compared to traditional techniques
Follow long-term preventive measures as directed
Schedule final follow-up to confirm successful treatment
Return to complete normal function with minimal restrictions
For Rubber Band Ligation:
Complete all necessary banding sessions (typically 2-4 sessions spaced 2 weeks apart)
Notice progressive improvement as each treated hemorrhoid resolves
No long-term recovery period required
Implement preventive strategies to reduce recurrence risk
Schedule follow-up to assess results and determine if additional treatment is needed
For Stapled Hemorrhoidopexy:
Complete internal healing within 3-4 weeks
Resume all activities with no restrictions by 2-3 weeks
Monitor for proper resolution of prolapse symptoms
Follow up to confirm successful treatment outcome
Implement long-term prevention strategies
For Hemorrhoidal Artery Ligation:
The full effect of the procedure may take 4-6 weeks as hemorrhoids gradually shrink
Schedule follow-up to assess results
Consider additional sessions if symptoms are not completely resolved
Implement preventive strategies for long-term success
Return to all normal activities with no restrictions
Long-Term Expectations
For All Hemorrhoid Treatment Approaches:
Most patients experience excellent long-term relief from hemorrhoid symptoms
Recurrence rates vary by procedure:
Traditional Excisional: Lowest recurrence rate (less than 5% at 5 years)
Laser Hemorrhoidectomy: Similar to traditional with slightly higher recurrence
Rubber Band Ligation: 30-50% recurrence over 5 years, but easily retreated
Stapled Hemorrhoidopexy: 15-30% recurrence at 5 years
Hemorrhoidal Artery Ligation: 20-30% recurrence at 5 years
Maintain long-term preventive measures:
High-fiber diet (25-30g daily)
Adequate hydration (8+ glasses of water daily)
Regular exercise
Avoiding prolonged sitting or straining
Prompt attention to bowel habits
Most patients report high satisfaction and improved quality of life
Post-procedure hygiene typically returns to normal within 6-8 weeks
Sexual function returns to normal once healing is complete
Annual rectal examination is recommended to monitor for recurrence
Minimal to no long-term functional changes for most patients
Improved comfort with sitting, physical activity, and bowel movements
Common Side Effects
For Traditional Excisional Hemorrhoidectomy:
Post-operative pain, typically significant for 7-10 days
Mild bleeding with bowel movements during healing
Temporary difficulty with urination in the first 24-48 hours
Anal discharge during the healing process
Itching during wound healing
Swelling in the anal area
Temporary changes in bowel habits
For Laser Hemorrhoidectomy:
Mild to moderate post-operative pain, typically less than traditional approaches
Minimal bleeding during recovery
Minor discharge during healing
Temporary swelling around the anal area
Itching sensation during healing
Reduced risk of urinary retention compared to traditional approaches
For Rubber Band Ligation:
Feeling of pressure or mild discomfort for 24-72 hours
Minor bleeding when the band falls off
A sensation of incomplete evacuation initially
The feeling of something in the rectum until the band falls off
Very mild pain compared to surgical approaches
For Stapled Hemorrhoidopexy:
Mild to moderate pain, typically less than with excisional techniques
Feeling of rectal pressure or urgency initially
Minor bleeding with initial bowel movements
Temporary difficulty with urination in some patients
Mild swelling around the anal area
For Hemorrhoidal Artery Ligation:
Minimal pain typically managed with over-the-counter medication
Sensation of rectal fullness if mucopexy was performed
Very minor bleeding in some cases
Temporary urgency with bowel movements
Less Common Complications
For Traditional Excisional Hemorrhoidectomy:
Infection of the surgical site (rare with proper care)
Excessive bleeding requiring intervention
Fecal impaction from avoiding bowel movements due to pain
Urinary retention requiring catheterization
Anal stenosis (narrowing) from scar tissue formation
Fecal incontinence (usually temporary)
Rectal perforation (extremely rare)
Delayed healing of surgical wounds
For Laser Hemorrhoidectomy:
Similar complications to the traditional approach but at lower rates
Thermal injury to surrounding tissues (rare with proper technique)
Device-related complications specific to laser technology
Reduced risk of stenosis compared to traditional approaches
For Rubber Band Ligation:
Severe pain if band placed too close to dentate line
Delayed bleeding when band falls off (typically days 7-10)
Thrombosis of external hemorrhoids
Pelvic sepsis (extremely rare but serious)
Vasovagal response during procedure causing lightheadedness
For Stapled Hemorrhoidopexy:
Persistent pain from staples (rare)
Rectal perforation (very rare)
Pelvic sepsis (extremely rare)
Rectal stenosis
Staple line dehiscence
Incomplete reduction of prolapsing tissue
Persistent urgency or tenesmus
For Hemorrhoidal Artery Ligation:
Rebleeding requiring additional treatment
Thrombosis of residual hemorrhoids
Urinary retention (more common in male patients)
Failure to identify all feeding arteries
Recurrence of symptoms due to development of collateral circulation
When to Seek Immediate Medical Attention
Excessive bleeding (more than a few tablespoons)
Severe pain not controlled by prescribed pain medication
Inability to urinate for more than 6-8 hours
Fever over 101°F (38.3°C)
Increasing redness, swelling, or purulent discharge from the surgical area
Severe constipation or inability to pass stool for more than 3 days
Persistent nausea or vomiting
Increasing abdominal pain or distension
Foul-smelling discharge from the rectal area
Significant lightheadedness or fainting
New onset of fecal incontinence
Severe rectal or pelvic pain that begins days after the procedure
Difficulty breathing or chest pain
For rubber band ligation: severe pain lasting more than a few hours after the procedure
For stapled procedure: persistent rectal bleeding or symptoms of bowel perforation
From your first consultation through your complete recovery, we provide:
Thorough evaluation and explanation of your condition
Clear discussion of all treatment options, including non-surgical alternatives when appropriate
Detailed pre-operative instructions to help you prepare
Compassionate care during your hospital stay or outpatient procedure
Comprehensive follow-up care and support during recovery
Ongoing availability to address questions or concerns
We understand that facing head and neck surgery can be intimidating, but you don't have to navigate this journey alone. Our team is committed to providing expert care with a personal touch, ensuring you feel supported, informed, and confident every step of the way.
Your health and wellbeing are our highest priorities, and we're honored to be part of your care team.
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All our laparoscopic procedures are performed by our highly trained surgical team using state-of-the-art equipment and techniques.
We're committed to providing you with the most advanced, minimally invasive options because we believe you deserve:
Less pain after surgery
Shorter hospital stays
Faster return to work and activities you enjoy
Smaller, less visible scars
Lower risk of complications
Better overall outcomes
Dr. Richard Nguyen is a board-certified General Surgeon with over 20 years of surgical expertise and fellowship training in Minimally Invasive and Bariatric Surgery from Vanderbilt University. Since establishing his practice in San Jose in 2007, he has pioneered innovative surgical techniques, including single-incision laparoscopic procedures and mastery of the da Vinci Robotic Surgical System. Beyond his acclaimed bariatric surgery practice, he has earned national recognition for his specialized expertise in both non-mesh and advanced mesh hernia repairs, while also serving as a critical approach surgeon for anterior spine access procedures. Dr. Nguyen combines technical precision with personalized care across multiple premier facilities throughout the South Bay Area.
I would refer Doctor Nguyen to anyone, in fact I have and they have all had the same experience as me. He is truly great. I owe all my success to Doctor Nguyen and I thank him for all the work he has done for me and continues to do so. He is extremely amazing, and I am very grateful to him.
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At 50, I now have a life I had only dreamed of a year before. My body tells me if I am done eating. This surgery is a tool that I have used to the fullest. It is not an easy way out. It still took work. But I honestly know that I would not be living this amazing new life if I didn’t step forward to embrace this life-saving surgery.
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Dr. Nguyen has changed my life completely. I feel so much better and I also feel like I’ve got control of my life again…I had high blood pressure, diabetes and cholesterol. I took at least 5 different medications for the past 30 years. NOW, after surgery I take no medications only vitamins!
Wondering which surgical procedure might be right for your condition? We're here to help you understand your treatment options and develop a personalized surgical plan. Contact our office today to schedule a consultation.
Your path to improved health may be more achievable than you think—with advanced surgical techniques leading to faster recovery, reduced complications, and a significantly enhanced quality of life.