THD uses a doppler to locate the terminating branches of the haemorrhoidal arteries. Once the artery is located the surgeon uses an absorbable suture to ligate or “tie-off” the arterial blood flow. The venous “out flow” remains to “shrink” the cushion. This is done without excision of tissue. If necessary the surgeon will perform a haemorrhoidopexy to repair the prolapse. Again, this is done with suture and no excision of tissue. This repair restores and “lifts” the tissue back to its anatomical position.