Piles (Haemorrhoids) Surgery in Delhi, India

Piles (haemorrhoids) surgery is a medical procedure performed to remove or shrink swollen veins in the lower rectum and anus. These swollen veins, known as haemorrhoids, can cause discomfort, pain, bleeding, itching, or a feeling of fullness. The surgery may involve removing the haemorrhoids, reducing their blood supply, or lifting them back into place using different techniques such as open surgery, stapling, laser treatment, or artery ligation. The choice of procedure depends on the severity and type of haemorrhoids.

Surgery for piles is usually recommended when the condition is advanced or persistent and significantly affects daily life. Some common reasons include:

• Persistent bleeding: When haemorrhoids bleed frequently and cause anaemia or discomfort.
• Severe pain or discomfort: When sitting, walking, or passing stool becomes painful.
• Prolapsed haemorrhoids: When internal haemorrhoids protrude outside the anus and do not go back on their own.
• Ineffective non-surgical treatments: When lifestyle changes, medications, or minimally invasive procedures fail to provide lasting relief.
• Recurrent haemorrhoids: When the problem keeps coming back despite earlier treatments.

Surgical intervention offers a permanent solution that helps relieve symptoms, prevent complications, and improve the overall quality of life.

When lifestyle changes and medication are not enough to treat problematic piles, doctors may recommend a procedure. These procedures vary in complexity, from simple daycare procedures to full surgery performed in the hospital. The best choice depends on the size and severity (grade) of the piles being treated.

Minimally Invasive Procedures 

These are used for smaller, internal piles (Grade I, II, and some Grade III). They usually do not require a major hospital stay and have a quicker recovery.

Rubber Band Ligation (Banding)

This is one of the most common procedures. The doctor uses a special instrument to place a tiny rubber band around the base of the internal pile. This safely cuts off the blood supply, causing the tissue to shrink and fall off (often unnoticed) within one to two weeks.

Sclerotherapy (Injection Treatment)

A chemical solution is injected directly into the pile tissue. This injection causes the haemorrhoid to scar, harden, and shrink, stopping any bleeding. It is often effective for small, bleeding internal piles.

Coagulation Therapy (Infrared or Laser)

This treatment uses focused heat (from an infrared light, a laser, or electric current) to create scar tissue at the base of the pile. By cutting off the blood supply, the heat causes the haemorrhoid to shrink and dry up.

External Piles Clot Removal (Thrombectomy)

If a very painful blood clot forms in an external pile, the doctor can perform a small incision to quickly remove the clot. This provides immediate relief and is most effective when done within the first few days.

Surgical Procedures (Hospital-Based)

These procedures are usually recommended for large, severe, or recurring piles (Grade III or IV), or extensive external piles that have not responded to minor treatments. They are performed in a hospital operation theatre under anesthesia (local, spinal, or general).

Haemorrhoidectomy (Traditional Surgery)

This is the surgical removal of the large, swollen haemorrhoid tissue using a scalpel or surgical instrument. It is widely considered the most effective treatment for severe cases, offering the best long-term results and the lowest chance of recurrence. However, it often requires more post-operative pain management and a longer recovery time, typically a few weeks. Note - The surgical wound may be closed with stitches (Closed Haemorrhoidectomy) or left open (Open Haemorrhoidectomy).

Stapled Haemorrhoidopexy (PPH or Stapling)

A circular stapling device is used to remove a ring of tissue above the piles. This action lifts the piles back to their correct position inside the anal canal and reduces their blood supply. Patients often experience less pain and a faster recovery compared to a conventional haemorrhoidectomy.

Haemorrhoidal Artery Ligation (HAL) / Transanal Haemorrhoidal Dearterialization (THD)

In this method, the surgeon uses an ultrasound-guided probe to find the exact arteries supplying blood to the piles. These arteries are then tied off with stitches (ligation). By stopping the blood flow, the piles gradually shrink. This is a less invasive surgical option known for potentially less pain and a quick recovery.

Laser Haemorrhoidoplasty

This modern surgical technique uses focused laser energy to shrink the haemorrhoid from the inside and seal the blood vessels. It is a minimally invasive approach that typically results in less pain and a shorter hospital stay and recovery time compared to traditional removal surgery.

It is essential to have an open discussion with your specialist doctor (Proctologist or Surgeon) to determine which procedure is the best and safest option for your specific condition.

Like any surgical procedure, piles (haemorrhoids) surgery carries certain risks, although serious complications are uncommon when performed by experienced surgeons. Understanding these risks helps patients make informed decisions and take proper post-operative care.

Some possible risks and complications include:

• Pain or discomfort: Mild to moderate pain is common after surgery, especially during bowel movements, and usually improves with medication and time.
• Bleeding: A small amount of bleeding may occur for a few days after surgery, which typically settles on its own.
• Infection: Although rare, there is a small risk of infection at the surgical site, which can be managed with antibiotics.
• Difficulty passing urine: Temporary urinary retention may occur in some patients, especially after spinal anaesthesia.
• Narrowing of the anal canal (stricture): Rarely, scar tissue may cause narrowing, which can be treated if required.
• Recurrence: In some cases, haemorrhoids can reappear over time, particularly if lifestyle factors are not addressed.

It is important to follow all post-surgery instructions carefully, maintain proper hygiene, and adopt healthy bowel habits to reduce the risk of complications and ensure smooth recovery.

The journey of piles (haemorrhoids) surgery generally follows a clear and structured process. Each stage plays an important role in ensuring the procedure is safe, effective, and followed by a smooth recovery.

Days before Piles (Haemorrhoids) Surgery

In the days leading up to the surgery, several steps are taken to prepare the patient for the procedure.

• A pre-surgical evaluation is conducted, which may include blood tests, physical examination, and other investigations to assess fitness for surgery.
• Any ongoing medications, especially blood thinners, may be reviewed or adjusted.
• In certain cases, bowel preparation is advised through dietary changes or mild laxatives.
• Fasting instructions are provided, usually beginning the night before the surgery.
• Arrangements are made for hospital admission and post-operative support at home.

These measures help minimise surgical risks and support a smooth operative course.

On the Day of Piles (Haemorrhoids) Surgery

The day of the procedure is carefully structured to ensure patient safety and comfort.

• The patient is admitted and necessary consent formalities are completed.
• Anaesthesia—local, spinal, or general—is administered depending on the surgical technique.
• The selected surgical procedure (open surgery, stapled haemorrhoidopexy, laser treatment, or other methods) is then carried out. Most procedures typically last between 30 and 60 minutes.
• After surgery, the patient is shifted to a recovery area, where vital signs are closely monitored as the effects of anaesthesia wear off.
• Depending on the patient’s condition, discharge may be allowed on the same day or after a short hospital stay for observation.

Post-Procedure Care 

Recovery is a crucial phase that supports healing and prevents complications.

• Mild discomfort is common after surgery and is managed with prescribed pain relief.
• The surgical site is kept clean and dry, and sitz baths are often recommended to reduce pain and aid healing.
• A high-fibre diet, adequate hydration, and stool softeners are commonly advised to make bowel movements more comfortable.
• Light physical activity is gradually resumed, while strenuous activities are avoided during the early recovery period.
• Follow-up appointments are scheduled to monitor healing and address any concerns.
• Most patients return to normal daily activities within a few days to weeks, depending on the surgical technique and overall health status.

Max Hospitals is one of India’s leading centres for colorectal and gastrointestinal care, offering advanced treatment for piles (haemorrhoids) with a strong emphasis on safety, precision, and long-term relief. Patients and their families trust Max Hospitals for the following reasons:

• Expert Colorectal Surgeons: A team of highly experienced surgeons with extensive expertise in performing various types of haemorrhoid surgeries, including open haemorrhoidectomy, stapled haemorrhoidopexy, laser treatment, and Doppler-guided procedures.
• Modern, Minimally Invasive Techniques: Advanced surgical methods are used to minimise pain, reduce bleeding, shorten hospital stays, and enable faster recovery.
• Comprehensive Pre- and Post-Surgery Care: From diagnosis and surgical planning to recovery and follow-up, care is tailored to each patient’s individual needs by a multidisciplinary team.
• Internationally Benchmarked Safety Protocols: All procedures are performed in NABH-accredited facilities, following stringent infection control measures and advanced anaesthesia protocols to ensure the highest standards of safety.
• State-of-the-Art Infrastructure: Modern operation theatres, high-precision instruments, and advanced monitoring systems support safe, efficient, and successful outcomes.
• Patient-Centred Approach: The focus goes beyond symptom relief, with personalised lifestyle guidance, dietary advice, and long-term follow-up to help prevent recurrence and support overall well-being.

What is the difference between internal and external piles?

Internal piles develop inside the rectum and are usually painless but may bleed. External piles occur around the anus and can be painful, itchy, or swollen.

How is the severity of piles determined?

The severity is classified into four grades based on size, symptoms, and whether the haemorrhoids protrude outside the anus. This grading helps decide the most appropriate treatment.

How long does the piles surgery procedure usually take?

Most procedures last between 30 and 60 minutes, depending on the type of surgery and the number of haemorrhoids being treated.

Is piles surgery done under general or local anaesthesia?

The choice of anaesthesia—local, spinal, or general—depends on the procedure type, patient preference, and medical condition.

Is hospital admission required for piles surgery?

Many minimally invasive procedures are performed as day-care treatments, allowing patients to go home the same day. Major surgeries may require an overnight or short hospital stay.

What kind of pain can be expected after surgery?

Mild to moderate pain is common, especially during bowel movements in the first few days. It typically improves with pain medication and proper wound care.

When can one resume normal activities after piles surgery?

Most patients resume light daily activities within a few days. Strenuous activities or heavy lifting may need to be avoided for a few weeks, as advised by the surgeon.

Can piles return after surgery?

Although surgery provides long-term relief, recurrence is possible if contributing factors such as chronic constipation or straining during bowel movements are not addressed.

What dietary changes are needed after piles surgery?

A high-fibre diet, plenty of fluids, and stool softeners are generally recommended to ensure smooth bowel movements and aid healing.

Is laser piles surgery better than traditional surgery?

Laser surgery is minimally invasive and often associated with less pain, quicker healing, and shorter hospital stays. However, the best option depends on the patient’s specific condition.

Will there be visible stitches after the procedure?

Some procedures involve stitches, while others do not. In cases where stitches are placed, they may dissolve on their own or be removed during a follow-up visit.

Can piles surgery affect bowel control?

Modern techniques are designed to protect sphincter muscles. Loss of bowel control is extremely rare when performed by experienced surgeons.

How soon can travel be planned after piles surgery?

Short-distance travel may be possible within a few days for minor procedures, but long-distance travel is best planned after a follow-up consultation.

Are there any restrictions on sitting or using the toilet after surgery?

Prolonged sitting should be avoided in the early recovery phase. Sitz baths and gentle hygiene are recommended to ease discomfort.

What kind of follow-up care is needed after piles surgery?

Follow-up visits are typically scheduled to monitor healing, manage any discomfort, and address early signs of recurrence, ensuring a smooth recovery.

Reviewed by Dr. Atul Wadhwa, Principal Consultant - General Surgery, Bariatric Surgery / Metabolic, Department of General Surgery and Robotics, on 02 February 2026