title: Transanal desarterialization guided by Doppler associated to anorectal repair in hemorrhoids: THD technic.
abstract: BACKGROUND
  Surgical treatment for hemorrhoids should be indicated individually and is based on the predominant symptom (bleeding or prolapse), severity of disease and the presence or absence of external component (plicoma). Surgeons must choose among varied techniques the one suitable for each case.
  The THD procedure consists of Doppler guided high ligation, selective to up six submucosal arterial branches that supply the hemorrhoids, leading to its desarterialization associated with prolapse repair (anorectal repair or lifting). It uses special equipment and kit.
  
  
  CONCLUSIONS
  THD technique has shown good initial results. Because surgical technique respects the anatomy, it acts directly on the pathophysiology of the disease and corrects its principal consequences; it looks quite promising. Its initial application may be in patients with hemorrhoids grade II, which have surgical indication, grades III and IV, the latter being associated with resection of plicomas.
authors: Discipline of Coloproctology, Faculty of Medicine, University of São Paulo, SP, Brazil. cwsobrado@hotmail.com
authors: Carlos Walter
authors: CW
authors: Sobrado-Junior
authors: José Américo Bacchi
authors: JA
authors: Hora
mesh_terms: D001003:Anal Canal / Q000098:blood supply / Q000601:surgery; D001158:Arteries / Q000601:surgery; D061865:Hemorrhoidectomy / Q000379:methods*; D006484:Hemorrhoids / Q000000981:diagnostic imaging* / Q000601:surgery*; D006801:Humans; D012007:Rectum / Q000098:blood supply / Q000601:surgery; D018608:Ultrasonography, Doppler