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
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