Minimally Invasive Techniques for Hemorrhoid Treatment
Hemorrhoids, a common anorectal condition, significantly impact the quality of life for millions worldwide. Traditionally, surgical hemorrhoidectomy has been the definitive treatment for advanced cases. However, advancements in medical technology have led to the development of several minimally invasive techniques (MITs) that offer reduced pain, shorter recovery times, and comparable efficacy for many patients [1]. This academic overview explores the landscape of MITs for hemorrhoid management, emphasizing their mechanisms, indications, and recent evidence.
Understanding Minimally Invasive Approaches
Minimally invasive techniques aim to alleviate hemorrhoidal symptoms by targeting the underlying pathophysiology—engorgement and prolapse of the hemorrhoidal cushions—with less tissue disruption than conventional surgery. These procedures are typically performed on an outpatient basis and are associated with fewer postoperative complications and discomfort [2]. The selection of an appropriate MIT depends on the grade of hemorrhoids, patient comorbidities, and surgeon expertise.
Key Minimally Invasive Techniques
Several MITs have gained prominence in recent years:
1. Transanal Hemorrhoidal Dearterialization (THD)
THD, also known as hemorrhoidal artery ligation, involves identifying and ligating the arterial blood supply to the hemorrhoids, thereby reducing blood flow and congestion. Concurrently, a mucopexy can be performed to lift and reposition prolapsed tissue. Studies, including those from 2023, have shown THD to be effective for Grade II and III hemorrhoids, with good medium-term results [1].
2. Laser Hemorrhoidoplasty (LH) / Hemorrhoid Laser Procedure (HeLP)
Laser-based treatments utilize laser energy to coagulate the hemorrhoidal tissue, leading to shrinkage and fibrosis. This technique is noted for its precision and has demonstrated improved outcomes in terms of pain and recovery compared to traditional methods [4] [6]. Recent systematic reviews and meta-analyses continue to evaluate its long-term efficacy against conventional treatments [6].
3. Hemorrhoid Artery Embolization (HAE)
HAE is an endovascular procedure where embolizing agents are used to block the arterial flow to the hemorrhoids. This technique has emerged as a safe and effective option, particularly for bleeding hemorrhoids, and is gaining traction globally [3] [8] [9]. Research from 2025 highlights its role as a novel approach for internal hemorrhoid treatment.
4. Rubber Band Ligation (RBL)
While one of the oldest MITs, RBL remains a cornerstone for Grade I and II internal hemorrhoids. It involves placing a rubber band at the base of the hemorrhoid, leading to necrosis and sloughing off of the tissue. Recent insights from 2024 continue to affirm its effectiveness as a painless way to remove internal hemorrhoids [14].
5. Infrared Coagulation (IRC)
IRC uses infrared light to coagulate the tissue above the hemorrhoid, causing it to shrink and scar. It is a quick, office-based procedure often used for small to medium-sized internal hemorrhoids. Recent advancements in 2023 have highlighted IRC as a revolutionary treatment option [10].
Recent Advancements and Future Directions
The field of hemorrhoid treatment is continuously evolving. Novel techniques such as Hemorrhoid Energy Therapy (HET) and Tissue Selecting Therapy (TST) stapler minimally invasive surgery are showing promising results in terms of safety and efficacy, even for severe hemorrhoids [12] [13]. These advancements underscore a broader trend towards less invasive, patient-centric approaches that prioritize rapid recovery and minimal discomfort.
Conclusion
Minimally invasive techniques have revolutionized the management of hemorrhoids, offering effective alternatives to traditional surgery for many patients. With ongoing research and technological innovation, the future of hemorrhoid treatment is poised to become even less invasive and more tailored to individual patient needs. It is crucial for healthcare professionals to stay abreast of these developments to provide optimal care, always considering the specific clinical context and avoiding generalized medical advice.
References
[1] Miyamoto, H. (2023). Minimally Invasive Treatment for Advanced Hemorrhoids. *PMC*. [https://pmc.ncbi.nlm.nih.gov/articles/PMC9876604/](https://pmc.ncbi.nlm.nih.gov/articles/PMC9876604/) [2] Surya, D. (2024). Precision and Power: A Comprehensive Review of Exploring.... *PMC*. [https://pmc.ncbi.nlm.nih.gov/articles/PMC11162813/](https://pmc.ncbi.nlm.nih.gov/articles/PMC11162813/) [3] Talaie, R. (2022). Hemorrhoid embolization: A review of current evidences. *ScienceDirect*. [https://www.sciencedirect.com/science/article/pii/S2211568421001704](https://www.sciencedirect.com/science/article/pii/S2211568421001704) [4] Yousefianzadeh, O. (2023). Minimally Invasive Laser Surgery vs. Common Techniques.... *IJMEDREV*. [http://www.ijmedrev.com/article_187055_75260629742a7c1412a0316a1f0b152b.pdf](http://www.ijmedrev.com/article_187055_75260629742a7c1412a0316a1f0b152b.pdf) [6] Wee, IJY. (2023). a systematic review and meta-analysis. *Coloproctol.org*. [https://coloproctol.org/journal/view.php?number=1975](https://coloproctol.org/journal/view.php?number=1975) [8] UCLA Health. (2025). A novel approach to internal hemorrhoids treatment. *UCLA Health News*. [https://www.uclahealth.org/news/article/hemorrhoidal-artery-embolization-novel-approach-internal](https://www.uclahealth.org/news/article/hemorrhoidal-artery-embolization-novel-approach-internal) [9] Columbia Radiology. (2025). When Hemorrhoid Symptoms Persist, a Minimally Invasive.... *Columbia Radiology*. [https://www.columbiaradiology.org/news/when-hemorrhoid-symptoms-persist-minimally-invasive-alternative-surgery](https://www.columbiaradiology.org/news/when-hemorrhoid-symptoms-persist-minimally-invasive-alternative-surgery) [10] Premier Surgical. (2023). The Latest Advancements in Hemorrhoid Treatment. *Premier Surgical*. [https://www.premiersurgical.com/12/the-latest-advancements-in-hemorrhoid-treatment-a-closer-look-at-infrared-coagulation-irc/](https://www.premiersurgical.com/12/the-latest-advancements-in-hemorrhoid-treatment-a-closer-look-at-infrared-coagulation-irc/) [12] Yadav, D. (2023). S219 Safety and Efficacy of Hemorrhoid Energy Therapy:.... *American Journal of Gastroenterology*. [https://journals.lww.com/ajg/fulltext/2023/10001/s219_safety_and_efficacy_of_hemorrhoid_energy.339.aspx](https://journals.lww.com/ajg/fulltext/2023/10001/s219_safety_and_efficacy_of_hemorrhoid_energy.339.aspx) [13] Huang, R. (2025). Tissue selecting therapy stapler minimally invasive surgery to.... *PMC*. [https://pmc.ncbi.nlm.nih.gov/articles/PMC12243282/](https://pmc.ncbi.nlm.nih.gov/articles/PMC12243282/) [14] Carolina Digestive. (2024). A Painless Way to Get Rid of Internal Hemorrhoids. *Carolina Digestive*. [https://www.carolinadigestive.com/blog-post/minimally-invasive-banding-a-painless-way-to-get-rid-of-internal-hemorrhoids](https://www.carolinadigestive.com/blog-post/minimally-invasive-banding-a-painless-way-to-get-rid-of-internal-hemorrhoids)