This procedure generally takes approximately 1 to 1½ hours to perform and requires that the patient be positioned face down on an operating table, or positioned on their back with their legs held up in stirrups. The area is cleaned and then each hemorrhoid will be clamped and tied off to prevent bleeding before being surgically removed. There is more than one method of removal that can be employed during a hemorrhoidectomy, with newer methods such as ultrasonic scalpels, cautery pencils and laser hemorrhoidectomy surgery quickly growing in popularity. If conventional methods are used to remove hemorrhoids, sutures will be required; whereas, if these newer methods are used, sutures are not needed. Another new procedure is sometimes coupled with hemorrhoidectomies, where surgeons staple healthy tissue in the area over the wound where hemorrhoids have been removed. While this procedure, called a stapled hemorrhoidectomy, seems to ease and hasten recovery, there is some evidence that this procedure may increase the risk of future complications.

Upon completion of the hemorrhoidectomy, patients are able to be driven home once the anesthesia has worn off and it is clear that any swelling in the area is not prohibiting urination. It is very common to experience pain during hemorrhoidectomy recovery, and most patients will be prescribed pain medication to assist with this. Pain medications that contain codeine may cause constipation, which can increase pain and discomfort during recovery; therefore, if constipation occurs, patients should alert their physician. Over the counter pain medications may also be recommended, as well as prescription or over the counter topical analgesic cream, gel or spray. Ice packs and frequents sitz baths, which are available as a sitz bath kit, help many patients manage pain and swelling during recovery, and high fiber foods and stool softeners are generally recommended for the first few weeks after surgery. Some bleeding is normal, particularly during the first few bowel movements after a hemorrhoidectomy; however, excessive bleeding should be reported right away.

After having a hemorrhoidectomy for the removal of hemorrhoids, patients can expect the recovery period to last at least two to three weeks and to have one or two follow-up appointments with their physician during this time. As patients recover from their hemorrhoidectomies, this is a good time to begin to plan and implement dietary and lifestyle changes to lower the chance of hemorrhoids returning in the future.

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