Surgical treatment should be performed whenever the habits and improve medical treatment are not sufficient or when there is already the onset of complications and generally for hemorrhoids of third and fourth grade or even second grade who did not respond to non-surgical alternative management. Hemorrhoidectomy is surgery used to remove the veins that are swollen or distended around the anus. For the intervention of the patient hemorrhoids can be subjected to general anesthesia or a local (local anesthesia or spinal anesthesia) with sedation. The dilated veins (hemorrhoids) are removed and the area is left in a package of sterile gauze to minimize bleeding.There are several types of surgical procedures for treatment of hemorrhoids can be divided into two: 1) a is the open technique, when performing resection or removal of hemorrhoids and leave it open to allow the wound to heal by secondary intention, 2 ) the other is the closed technique, where the hemorrhoidal tissue is removed and the affected mucosa of the anal canal and the edges of the wound is closed to let her face again. Other techniques include the use of staples, they are inserted through the anus and clamped and cut redundant tissue, making a hemorrhoidopexy. The newest treatment is laser hemorrhoidectomy, which allows operation with either local anesthesia or zonal and the patient can resume normal life in a day or two. Although this technique has not demonstrated a clear advantage over traditional techniques when you increase the cost of surgery and required specialized equipment and instrumental.During convalescence the patient may experience severe pain after surgery when contracts or relaxes the anus, so it should be given painkillers. To avoid the use of paper over the anus, should be used in bidet washing after defecation. Also, warm baths will help to reduce painful contractions of the anus, and can soothe the itching and burning in the area. You can expect a full recovery within two weeks. Intrathecal analgesia has demonstrated a significant reduction in pain in the patient after the operation in the first 24 hours.