THD™ Transanal Hemorrhoidal Dearterialization™

THD or transanal hemorrhoidal dearterialization is a new and effective surgical treatment for hemorrhoids that eliminates the need to cut tissue. As a result, patients typically experience less pain and faster recovery than with traditional approaches. It can be used to treat all grades of active hemorrhoids and is recommended when changes in diet/lifestyle, medication and other treatments have not been effective. Before doing THD, a complete analysis of the patient’s hemorrhoidal history helps the doctor determine the best treatment plan.


Before the THD procedure begins, to prevent any discomfort you will be given general or local anesthesia as well as one or two enemas. The surgeon uses a specialized light and Doppler ultrasound probes to accurately map and cut off the problem blood overflow, then reposition tissue into its correct location within the anal track. Sutures (stitches) are applied at the locations affected; these cannot be felt by the patient.

Following your procedure, we will keep you under observation until the effects of the sedative/anesthesia have worn off. Patients typically recover completely within 3 days or less. Post-operative complications or hemorrhoid recurrence following treatment are extremely rare. Please note that THD is not currently covered by OHIP.

Because you will receive anesthesia as part of THD, you may not drive or operate machinery for the rest of the day. You must arrange for another adult to take you home after your procedure.You can expect to be at the clinic for 2 ½ to 3 hours.

Stop taking any ASA, blood thinning or iron medication 5 days before your procedure. For other medications, please check with your doctor.

The night before your THD, do not eat or drink anything after midnight. You must have an empty stomach for the procedure.

  • Starting at 6:00 pm the evening before your colonoscopy, drink one 250 ml (8 ounce) glass of the Peglyte solution every 15 minutes, taking 8 glasses in all for a total of 2 litres.
  • Wake up at 6:00 am the morning of your procedure and drink the remaining 8 glasses (2 litres) of Peglyte solution before 8 a.m.

Patient Forms

Once you have an appointment for a procedure at North York Endoscopy Clinic, please download and print out all the forms below. Fill out the information requested and bring the completed forms with you to your appointment.

Patient Forms
Consent Form Download Form
Patient Forms
COVID Screening Form Download Form
Patient Forms
Medical Information Form Download Form
Patient Forms
Patient Waiver Form Download Form