HAL or THD procedures for treatment of hemorrhoids are used in more severe cases.  These methods consist in Doppler (ultrasound) localization of blood vessels feeding hemorrhoids and their subsequent suture ligation. The hemorrhoids gradually shrink because they do not have any blood supply. The protruding hemorrhoids are replaced inside anal canal with internal sutures placed above the dental line. In this area there are no nerves and the sutures cause moderate pain. The surgery requires slight sedation, is minimally invasive ( there is no resection) and relatively painless. Postoperatively, the patient is hospitalized for a few hours. The postoperative results are very good.