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 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)
Enlarged Internal Hemorrhoid
Enlarged Internal Hemorrhoid with Prolapse
What Causes Hemorrhoid Disease? Patients with symptomatic Hemorrhoids appear to have excess blood flow into their Hemorrhoids.
What Causes Hemorrhoid Disease? Vessels Connective tissue Over time, this excess blood flow causes tissues to swell and stretch.
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?
Surgical Treatments More Invasive Traditional surgery Stapled hemorroidopexy  (PPH) Transanal hemorrhoidal dearterialization (THD) Hemorrhoidal  tissue excision Rectal mucosal tissue excision No excision Less Invasive
Surgical Treatments
What is THD? “Transanal Hemorrhoidal Dearterialization” THD treats the sourceof 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)
THDProcedure 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
David Zeiler, M.D. Triangle Surgical Associates 115 Crescent Commons Drive Suite 200 Cary, NC 27518  (919) 851-5055  Patient Education Please ask me for a THD patient education brochure
The End uranus
   Thank You! 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 THD: Treating the Source – Not the Symptoms

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THD Procedure for Hemorrhoids: A Kinder, Gentler Approach - Presented by David Zeiler, M.D. at WakeMed's Men's Health Event on 9/21/11

  • 1.
  • 2. THD America THD Procedure for Hemorrhoids A Kinder Gentler Approach David Zeiler, M.D.
  • 3. Who Has Hemorrhoids? Actually, you do! EVERYONE does!
  • 5. 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
  • 6. Causes low-fiber diets straining with defecation Prolonged sitting on a toilet (eg, while reading) Pregnancy Age Genetics
  • 7. Hemorrhoid Symptoms Bleeding: bright red blood in the toilet or on toilet tissue Pain Discomfort: itching and or burning Swelling Prolapse (protruding hemorrhoid tissue)
  • 10. What Causes Hemorrhoid Disease? Patients with symptomatic Hemorrhoids appear to have excess blood flow into their Hemorrhoids.
  • 11. What Causes Hemorrhoid Disease? Vessels Connective tissue Over time, this excess blood flow causes tissues to swell and stretch.
  • 12. Eventually, swelling and stretching may lead to varying degrees of symptoms.
  • 13. 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. 
  • 14. Hemorrhoid Treatments Diet / Drugs Injection sclerotherapy Cryotherapy Photocoagulation Rubber Band Ligation Surgery
  • 16. Hemorrhoid Treatments Why might I consider a surgical treatment for my Hemorrhoids?
  • 17. Surgical Treatments More Invasive Traditional surgery Stapled hemorroidopexy (PPH) Transanal hemorrhoidal dearterialization (THD) Hemorrhoidal tissue excision Rectal mucosal tissue excision No excision Less Invasive
  • 19. What is THD? “Transanal Hemorrhoidal Dearterialization” THD treats the sourceof 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
  • 20. Tying off of Hemorrhoidal Artery
  • 21. Lifting of Hemorrhoidal Prolapse (Pexy)
  • 23. THDProcedure 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
  • 24. David Zeiler, M.D. Triangle Surgical Associates 115 Crescent Commons Drive Suite 200 Cary, NC 27518  (919) 851-5055  Patient Education Please ask me for a THD patient education brochure
  • 26. Thank You! 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 THD: Treating the Source – Not the Symptoms