HAL / THD with Mucopexy
Doppler-guided ligation of haemorrhoidal arteries combined with mucopexy to simultaneously lift and fix prolapsed tissue - treating both the blood supply and prolapse components without tissue excision.
What is HAL / THD with Mucopexy?
Haemorrhoidal Artery Ligation (HAL) - also known as Transanal Haemorrhoidal Dearterialisation (THD) - uses a Doppler probe to precisely locate and ligate the terminal branches of the superior rectal artery supplying each haemorrhoidal cushion. Combined with Mucopexy - a running suture that lifts and fixes prolapsed mucosal tissue - the procedure addresses both the blood supply excess and the prolapse component of haemorrhoid disease. Dr. Samhitha Reddy performs HAL/THD with Mucopexy at Lux Hospitals, Hyderabad as a sphincter-preserving surgical option for Grade II–III haemorrhoids. Because no tissue is excised, post-operative pain is significantly reduced and there are no open wounds - making it an attractive option for patients who prefer to avoid traditional excisional piles surgery in Hyderabad.
How the Procedure Works
Anaesthesia
Spinal or general anaesthesia. Patient in lithotomy. Enema bowel preparation prior to surgery.
Doppler Probe Insertion
The HAL/THD proctoscope with built-in Doppler probe is inserted. The probe identifies audible Doppler signals at each haemorrhoidal artery.
Arterial Ligation
A figure-of-eight absorbable suture is placed at each identified artery - typically 6–8 arteries in 3–4 quadrants - ligating the blood supply to each haemorrhoidal cushion.
Mucopexy
A continuous running suture is placed from above each ligation point downward, gathering and lifting prolapsed mucosal tissue back to its correct anatomical position.
Discharge
Procedure takes 20–30 minutes. Hospital stay typically 1 day. Return to normal activity in 5–7 days. Very low post-operative pain compared to excisional surgery.
Outcomes
Who Needs This Treatment?
- →No tissue excision - no open wounds and significantly less post-operative pain
- →Doppler guidance ensures precise arterial ligation with no adjacent structure damage
- →Simultaneously addresses blood supply and prolapse in a single procedure
- →Shorter recovery than haemorrhoidectomy - return to work in 5–7 days
- →Very low risk of anal stenosis or sphincter damage
- →Suitable for patients who wish to avoid more invasive excisional piles surgery
HAL/THD with Mucopexy is a physiological approach - we work with the body's anatomy rather than excising it away. Patients with prolapsing haemorrhoids are particularly pleased with how well the mucopexy addresses that uncomfortable bearing-down sensation.
— - Dr. Samhitha Reddy, Consultant Proctologist & Laparoscopic Surgeon
Common Questions
Frequently Asked
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