THD America

THD Procedure for Hemorrhoids A Kinder

Gentler Approach

David Zeiler, M.D.

Who Has Hemorrhoids?

Actually, you do!EVERYONE does!

Normal Anatomy

Normal Hemorrhoid

An Ancient problem

• Hippocrates (460-377 BC) Wrote: On Hemorrhoids (400 BC) - A treatise on the nature and treatment of hemorrhoids, a pain in the rectum

Causes

• low-fiber diets • straining with defecation• Prolonged sitting on a toilet (eg,

while reading)• Pregnancy• Age• Genetics

Hemorrhoid Symptoms

• Bleeding: bright red blood in the toilet or on toilet tissue

• Pain

• Discomfort: itching and or burning

• Swelling

• Prolapse (protruding hemorrhoid tissue)

EnlargedInternal

Hemorrhoid

Enlarged Internal Hemorrhoid with Prolapse

What Causes Hemorrhoid Disease?

Patients with symptomatic Hemorrhoids appear to have excess blood flow into their Hemorrhoids.

Healthy In-dividual

Hemorrhoid Patient

0

5

10

15

20

25

30

Arteries have excess FLOW

Flow(cm/sec)

Connective tissue

Over time, this excess blood flow causes

tissues to swell and stretch.

Vessels

What Causes Hemorrhoid Disease?

Eventually, swelling and

stretching may lead to varying

degrees of symptoms.

You Are Not Alone!

• Hemorrhoids affect up to 86% of Americans and has no age barrier.

• Hemorrhoids are a condition that will happen to 50% of Americans by the age of 50.

• Hemorrhoids can occur at any age but are more common as people get older.

• Among younger people, they are most common in women who are pregnant or have had a child. 

Hemorrhoid Treatments

• Diet / Drugs• Injection sclerotherapy• Cryotherapy• Photocoagulation• Rubber Band Ligation • Surgery

Rubber Band Ligation

Hemorrhoid Treatments

Why might I consider a surgical treatment for my Hemorrhoids?

Hemorrhoidal tissue excision

Rectal mucosaltissue excision

No excision

Traditionalsurgery

Stapled hemorroidopexy (PPH)

Transanal hemorrhoidal dearterialization(THD)

Surgical Treatments

Less Invasive

More Invasive

Surgical Treatments

What is THD?

“Transanal Hemorrhoidal Dearterialization”

•THD treats the source of Hemorrhoid disease, not the symptoms•THD uses sound waves to locate the hemorrhoidal arteries•Once each artery is located the surgeon ties off the blood flow•If necessary your surgeon will repair the prolapse which restores and “lifts” the tissue back to a more natural position•No tissue is cut or excised•THD is performed as an out-patient surgery•Most patients get back to normal activities within 4 days

Tying off of Hemorrhoidal Artery

Lifting of Hemorrhoidal Prolapse (Pexy)

Completion of Hemorrhoidal Lift (Pexy)

THD Procedure Benefits Summary

• Minimally-invasive– No excision of tissue, low/minimal complication rates– Operation in low/no pain zone of anal canal– Surgeon can hear and see that arteries are tied off– Venous outflow remains to dissipate blood supply

• Restoration of prolapsed tissue (Lifting)• Minimized post-op pain and discomfort• Patients back to normal activities within 4 days

Patient Education

Please ask me for a THD patient

education brochure

David Zeiler, M.D.

Triangle Surgical Associates

115 Crescent Commons Drive 

Suite 200 Cary, NC 27518

 

(919) 851-5055 

The End

uranus

David Zeiler, M.D.Triangle Surgical Associates

115 Crescent Commons Drive Suite 200 

Cary, NC 27518

 (919) 851-5055 

Mon - Fri 9:00am - 5:00pm

Thank You!

THD: Treating the Source –Not the Symptoms