Hemorrhoidopexy: What It Is, Procedure & Recovery
Updated: 3 days ago
Written and medically reviewed by Dr. Baraa Alnahhal, MD · Last reviewed: November 2026 · How we review
Quick Answer
A hemorrhoidopexy, also called stapled hemorrhoidopexy, is surgery for large or prolapsed internal hemorrhoids. Instead of cutting the hemorrhoids out, the surgeon uses a stapler to lift them into the rectum and cut off their blood supply. It takes 30 to 45 minutes, most people go home the same day, and healing takes a couple of weeks.
What the research says
In the eTHoS trial of 777 patients, stapled hemorrhoidopexy was less painful than traditional hemorrhoidectomy in the short term, but quality of life over 24 months was better after traditional surgery (Watson et al., The Lancet, 2016) [2].
Serious complications were similar: 7% after stapled hemorrhoidopexy vs 9% after traditional surgery [2].
A Cochrane review found hemorrhoids came back more often after stapled surgery: 37 of 479 patients vs 9 of 476 after conventional surgery (Lumb et al., Cochrane Database of Systematic Reviews, 2006) [3].
Key takeaways
Hemorrhoidopexy treats internal hemorrhoids only, not external ones.
It's usually for severe or prolapsed hemorrhoids that haven't improved with home care.
It often hurts less and allows a quicker return to light activity than hemorrhoidectomy.
Hemorrhoids are more likely to come back than after traditional surgery.
It needs special equipment and training, so not every hospital offers it [1].
What is a hemorrhoidopexy?
Hemorrhoids are swollen veins in and around the anus and rectum. Internal hemorrhoids form inside the rectum. When they get large, they can slip down and bulge out of the anus. This is called prolapse [1].
In a stapled hemorrhoidopexy, the surgeon doesn't remove the hemorrhoids directly. Instead, a ring of tissue above them is stapled, which pulls the hemorrhoids back into their normal position and cuts off their blood supply. Over time, they shrink [1].
Feature | Stapled hemorrhoidopexy | Traditional hemorrhoidectomy |
How it works | Lifts and staples hemorrhoids back into place | Cuts hemorrhoids out |
Treats | Internal hemorrhoids only | Internal and external hemorrhoids |
Pain after surgery | Usually less | Usually more |
Chance of coming back | Higher | Lower |
Hemorrhoidopexy trades less pain for a higher chance of recurrence.
Who might need a hemorrhoidopexy?
Most hemorrhoids get better with simple steps like more fiber, more water, over-the-counter creams and warm sitz baths. Office treatments such as hemorrhoid banding are often tried next [1].
A hemorrhoidopexy may be an option if you have [1]:
Large internal hemorrhoids
Prolapsed hemorrhoids that bulge out of the anus
Severe symptoms that haven't improved with diet changes, medicines or sitz baths
It's not used for external hemorrhoids. Your surgeon will help you choose between hemorrhoidopexy, hemorrhoidectomy and other options based on your symptoms and goals.
How to prepare
Before surgery, your care team may ask you to [1]:
Stop eating and drinking for several hours
Adjust or pause certain medicines
Empty your colon with a laxative or enema
Stop smoking and avoid alcohol before and after surgery
Arrange a ride home, since you can't drive yourself
How is hemorrhoidopexy done?
You'll receive anesthesia through an IV so you don't feel pain. The surgeon then [1]:
Gently stretches the anal canal with a dilator.
Places a circular (purse-string) stitch in the rectal tissue just above the hemorrhoids.
Inserts a circular stapling device.
Ties the stitch to pull the hemorrhoid tissue up into the stapler.
Fires the stapler to remove a ring of excess tissue and staple the hemorrhoids back in place.
The procedure usually takes about 30 to 45 minutes.
Recovery after hemorrhoidopexy
Most people go home the same day. Some pressure and soreness are normal, and your provider may prescribe pain medicine. A gauze or foam dressing may be placed and usually comes out with your first bowel movement [1].
Time after surgery | What to expect |
Same day | Go home; grogginess or nausea as anesthesia wears off |
First bowel movement | Dressing passes out |
About 2 weeks | Most healing is done |
2 to 4 weeks | Return to more demanding activities |
Light activities can usually restart sooner than after traditional hemorrhoid surgery [1].
To keep bowel movements soft and comfortable [1]:
Take a stool softener
Eat high-fiber foods
Drink plenty of water
Take warm sitz baths
Avoiding constipation and straining also helps prevent hemorrhoids from coming back.
Benefits
Hemorrhoidopexy can treat severe and prolapsed internal hemorrhoids with a minimally invasive approach. It often causes less pain than traditional hemorrhoidectomy, and many people have a shorter hospital stay and quicker recovery [1].
Risks and complications
Possible risks include [1]:
Bleeding, which may happen a few days after surgery
Hemorrhoids coming back, which is more likely than with traditional surgery
Infection (rare)
Damage to the anal sphincter muscle (rare)
In the Cochrane review, people who had stapled surgery were also more likely to need another operation later [3].
When to call your doctor
Call your care team if you have heavy bleeding, fever, severe or worsening pain, or trouble passing urine or stool after surgery.
Conclusion
Stapled hemorrhoidopexy is a good option for some people with large or prolapsed internal hemorrhoids who want less pain and a faster return to daily life. The trade-off is a higher chance that hemorrhoids return. Talk to a colorectal surgeon about which procedure fits your symptoms best. If you're pregnant, read our guide to hemorrhoids during pregnancy first.
FAQ
What is a stapled hemorrhoidopexy?
It's surgery that uses a circular stapler to lift large internal hemorrhoids back into the rectum and cut off their blood supply so they shrink [1].
Is hemorrhoidopexy better than hemorrhoidectomy?
It usually hurts less at first, but traditional surgery gave better quality of life over 24 months in a large trial and has fewer recurrences [2][3].
How long does hemorrhoidopexy take?
The procedure usually takes about 30 to 45 minutes [1].
How long is recovery after hemorrhoidopexy?
Most healing takes a couple of weeks. Avoid demanding activities for 2 to 4 weeks [1].
Is hemorrhoidopexy painful?
Some pressure and soreness are normal, but it often causes less pain than traditional hemorrhoidectomy [1].
Can hemorrhoids come back after hemorrhoidopexy?
Yes. Recurrence is more likely than after traditional surgery: 37 of 479 vs 9 of 476 patients in one review [3].
Does hemorrhoidopexy treat external hemorrhoids?
No. It's only used for internal hemorrhoids [1].
Will I go home the same day?
Most people go home the same day after a hemorrhoidopexy [1].
What are the risks of hemorrhoidopexy?
Bleeding and hemorrhoids coming back are most common. Infection and sphincter damage are rare [1].
How can I make bowel movements easier after surgery?
Use a stool softener, eat high-fiber foods, drink plenty of water and take warm sitz baths [1].
How do I prepare for a hemorrhoidopexy?
Your surgeon may ask you to stop eating and drinking for several hours, pause certain medicines, empty your colon with medicine or an enema, and arrange a ride home [1]. You should also stop smoking and avoid alcohol before and after surgery [1].
When should I call my doctor after a hemorrhoidopexy?
Contact your surgeon if you have a lot of pain or swelling, bleed a lot from your rectum, or have a fever [4]. Also call if you can't pass urine several hours after surgery or can't have a bowel movement because of pain [4].
Related Reading
Learn more in our guide to Hemorrhoid Banding.
Learn more in our guide to Hemorrhoids During Pregnancy.
Learn more in our guide to Constipation.
Learn more in our guide to Anal Fissures.
References
Cleveland Clinic. Hemorrhoidopexy: What It Is, Procedure & Recovery. Cleveland Clinic Health Library. Updated March 4, 2026. https://my.clevelandclinic.org/health/procedures/hemorrhoidopexy
Watson AJM, Hudson J, Wood J, et al. Comparison of stapled haemorrhoidopexy with traditional excisional surgery for haemorrhoidal disease (eTHoS): a pragmatic, multicentre, randomised controlled trial. Lancet. 2016;388(10058):2375-2385. PMID 27726951. https://doi.org/10.1016/S0140-6736(16)31803-7
Lumb KJ, Colquhoun PH, Malthaner RA, et al. Stapled versus conventional surgery for hemorrhoids. Cochrane Database Syst Rev. 2006;(4):CD005393. PMID 17054255. https://doi.org/10.1002/14651858.CD005393.pub2
MedlinePlus. Hemorrhoid removal - discharge. MedlinePlus. Updated July 9, 2025. https://medlineplus.gov/ency/patientinstructions/000674.htm
Medical disclaimer
This article is for general education only and does not replace advice from a qualified healthcare professional. Talk to your doctor about your own diagnosis and treatment, and seek emergency care right away for severe or sudden symptoms.
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