Anal Surgery for Hemorrhoids Periprocedural Care

Updated: Jul 12, 2021
  • Author: Vassiliki Liana Tsikitis, MD, MCR, MBA, FACS, FASCRS; Chief Editor: Kurt E Roberts, MD  more...
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Periprocedural Care


For all treatments, a conventional anal retractor (eg, a Parks or Fansler retractor) is required. For hemorrhoidectomy, the following additional equipment is required:

  • Scalpel
  • Scissors
  • Diathermy
  • Absorbable suture (if the open surgical wound is closed)

Patient Preparation


For office treatments, local anesthesia is used. For surgical treatments, general anesthesia or local anesthesia combined with mild sedation may be used. No matter what type of anesthesia is employed, the procedure begins with local injection of the entire anal canal with bupivacaine or lidocaine with epinephrine.


For both office and surgical treatments, place the patient in a jack-knife prone, lithotomy, or left lateral decubitus position.