Hello  A number of surgical techniques may be used if conservative medical management fails.  Hemorrhoidectomy is a surgical excision of the hemorrhoid used primarily only in severe cases.  Doppler-guided, transanal hemorrhoidal dearterialization is a minimally invasive treatment using an ultrasound doppler to accurately locate the arterial blood inflow. These arteries are then tied off and the prolapsed tissue is sutured back to its normal position.  Stapled hemorrhoidectomy, or, more properly, stapled hemorrhoidopexy, is a procedure that involves the resection (removal) of much of the abnormally enlarged hemorrhoidal tissue.It is generally less painful than complete removal of hemorrhoids, and is associated with faster healing compared to a hemorrhoidectomy. You must consult your surgeon and discuss the various surgical options with him and opt for the procedure which suits you the best. Thanks