The most common surgical treatment of hemorrhoids is the “hemorrhoidectomy”, where external and/or internal hemorrhoids are removed. This is a tried and true operation that has been proven highly effective for relieving the patient’s hemorrhoid problems for the long term. Depending on the extent of the patient’s hemorrhoid problem, the procedure is performed with one, two or three separate incisions. Once the tissue is removed, sutures are used to repair the anal canal; the sutures are absorbable stitches and do not need to be removed. The operation is almost always done as an outpatient with deep sedation and local anesthetic. The patient remains asleep the entire operation and will not sense any discomfort during the surgery. The early down side on the surgery is that post-operative period will be painful. Patients need to anticipate at least a two week recovery at home during which they need to do frequent sitz baths, take the pain medications prescribed and remain on stool softeners and fiber supplements to make passage of their bowels easier. The surgical options and all the ramifications of the choices as well as the potential risks will be discussed with the patient at the time of their consultation with the surgeon.