Concierge coloproctology · London
Private haemorrhoidectomy in London, by a consultant colorectal surgeon.
The definitive operation for Grade III–IV piles — with the technique that fits your case, the anaesthetic that suits you, and honest expectations about the fortnight afterwards.
Why patients choose us
- 01
A consultant coloproctologist, in theatre
Not a walk-in clinic and not a training list. A named colorectal surgeon, a proper theatre, and the anaesthetic that suits you.
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The right operation for the right grade
Haemorrhoidectomy is definitive but painful. If HAL, banding or a laser option fits better, we say so before you commit.
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Independent, and free
We are paid by no clinic, so the recommendation is impartial and costs you nothing.
Indicative pricing
What a private haemorrhoidectomy costs in London.
Indicative ranges across our partner clinics. Send the details and we quote firm figures across two or three options.
In short
A Milligan-Morgan in our network: £3,000–£5,000, day-case or one night in.
| Procedure | Indicative range | Typical duration | Recovery |
|---|---|---|---|
| Milligan-Morgan (open) haemorrhoidectomy | £3,000–£5,000 | 30–60 min | Day-case or 1 night |
| Ferguson (closed) haemorrhoidectomy | £3,200–£5,200 | 45–60 min | Day-case or 1 night |
| LigaSure / Harmonic energy haemorrhoidectomy | £3,500–£5,500 | 30–45 min | Day-case usually |
| Laser haemorrhoidoplasty (LHP) | £3,200–£4,800 | 30 min | Day-case |
| Stapled haemorrhoidopexy (PPH) — rarely used | On request | 30 min | Day-case |
| Consultation only | £220–£400 | 30 min | Same visit |
Prices vary by clinic, by which surgeon does the case, by the anaesthetic and technique chosen, and by whether you stay a night. We come back with a firm quote within one working day.
The problem
The right operation, the right surgeon, the right expectations.
Haemorrhoidectomy is often booked before less painful options are considered, and often booked without a frank conversation about the fortnight of recovery. We fix both before you commit.
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Not sure surgery is needed?
For Grade I–II, banding often does it. For Grade II–III with prolapse, HAL may be enough. We say so before booking excision.
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Worried about the recovery?
Two weeks of significant pain is honest. A proper analgesia plan — including a topical GTN or diltiazem and a stool softener — is set up in advance.
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Want it done properly?
A named consultant colorectal surgeon on the ACPGBI register, a proper theatre, and the technique that fits your grade of disease.
The journey
From enquiry to recovery — what happens, in order.
One clinician from first message to review — including the two-week recovery window.
Phase 1 · Before your procedure
Concierge, off-stage for you
Phase 2 · On the day
A day at the clinic
Phase 3 · After
Concierge, back on
- 01
Before
You tell us what is going on
A short, confidential form. Bleeding, prolapse, pain, what you have already tried — banding, HAL, creams.
- 02
Before
We come back with a recommendation
Within one working day: the right operation, the right anaesthetic, an indicative price. If a less invasive option fits, we say so.
- 03
Before
We arrange the appointment
Usually within two to three weeks. Blood-thinners are reviewed with the team and you are told exactly how to prepare.
- 04
On the day
Arrival at the clinic
Arrival, consent and a chat with the surgeon and anaesthetist. Spinal or GA — whichever was chosen — and lithotomy or prone jack-knife on the table.
- 05
On the day
The procedure itself
30 to 60 minutes in a proper theatre. The three haemorrhoidal cushions excised, pedicles ligated with vicryl, careful haemostasis.
- 06
On the day
Day-case or one night in
Day-case for most; one night in if there is any concern about pain control or urinary retention. Written aftercare and a phone number.
- 07
After
Recovery and review
Significant pain for the first two weeks — it is the honest truth. Full recovery three to four weeks. A review is arranged.
Typical end-to-end: 2–3 weeks from enquiry to theatre. Full healing: 3–4 weeks.
When it helps
When haemorrhoidectomy is the right step.
The situations we see most, plus the red flag that means a colonoscopy first — not a haemorrhoid operation.
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Grade III haemorrhoids
Prolapse with straining that has to be pushed back manually — often the tipping point into surgery.
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Grade IV haemorrhoids
Permanently prolapsed piles that will not reduce — a definitive operation is usually needed.
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Mixed internal and external disease
Internal piles with a thrombosed external component — banding will not fix the outside, excision does.
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Failed HAL or banding
Recurrent bleeding or prolapse after minimally-invasive treatment — definitive excision is the next step.
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Recurrent significant bleeding
Piles that bleed enough to drop your iron — after other causes are excluded on colonoscopy.
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Patient preference for a cure
Some patients want the definitive operation up front rather than a staged, less-invasive route.
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Skin tags and hygiene
Large external tags that make hygiene difficult can be dealt with at the same operation.
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Red flag: change in bowel habit
New bleeding with a change in habit, weight loss or a family history of bowel cancer is a colonoscopy first — not a haemorrhoid list.
Procedure options
Excisional haemorrhoidectomy is not the only option.
What each technique actually involves — and which fits which grade of disease.
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Milligan-Morgan (open) — UK gold standard
The three haemorrhoidal cushions are excised and the pedicles ligated with vicryl. Wounds are left open to heal — hence “open”.
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Ferguson (closed) haemorrhoidectomy
The same excision, but the mucosa is re-approximated with a running suture. More common in the US than the UK.
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LigaSure / Harmonic haemorrhoidectomy
Energy-device excision. Less bleeding on the table and, in trials, less pain in the first week than scissor-and-tie.
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Laser haemorrhoidoplasty (LHP)
A diode laser shrinks the haemorrhoidal tissue from within. Evidence is emerging; less pain, but longer-term durability is still being defined.
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Stapled haemorrhoidopexy (PPH)
A circumferential mucosectomy above the dentate line. Now rarely offered in the UK after ACPGBI review of prolapse recurrence and rare, serious complications.
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HAL — a less painful alternative
Haemorrhoidal artery ligation with recto-anal repair. A separate operation — worth considering for Grade II–III before excision.
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Rubber band ligation
An outpatient option for Grade I–II internal piles. Not a fix for external disease or full prolapse — but the right first step for many.
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Consultation only
An honest discussion of whether an operation is needed at all, and which option fits — no obligation.
Our vetted London network
A small panel of colorectal surgeons, we picked them.
Consultant colorectal surgeons across central, north, west and south London. Not listed publicly — introductions are made privately, once we understand your case.
Selection criteria
How we choose every surgeon in our network.
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Consultant colorectal surgeons on the ACPGBI register
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Spinal and GA both available, with a substantive anaesthetist
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HAL, banding and laser options offered — not just excision
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Day-case pathway with a same-week phone-call review
Safety and recovery
What to expect afterwards — honestly.
Haemorrhoidectomy has a durable cure rate over 90% at five years and patient satisfaction of 85–95% at a year — weighed against a fortnight of real pain and a small but not zero risk of secondary bleeding.
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Pain for two weeks — the honest answer
Excisional haemorrhoidectomy hurts. Paracetamol, an NSAID, a weak opioid, lactulose and a topical GTN or diltiazem are usually all needed for the first week.
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The first bowel motion is the dreaded one
A stool softener from day one, warm sitz baths and plenty of fluids. It is uncomfortable but rarely as bad as feared once softeners are on board.
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Secondary bleeding, day 7–14
Around 2–5% of patients have a secondary bleed as sutures dissolve. Most settles; a small number need a return to theatre.
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Urinary retention, 5–10%
Common in the first 24 hours, especially after a spinal. An overnight catheter fixes it — one of the reasons some patients stay a night.
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Faecal incontinence — usually temporary
Some urgency and minor leakage is common for weeks. Permanent incontinence is uncommon (around 2–5%), more likely in older or multiparous patients.
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Anal stenosis, 1–3%
Rare, and largely avoided by leaving mucosal bridges between excision sites. The historical Whitehead deformity is a lesson, not a modern technique.
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Recurrence 5–15% at five years
Better than HAL or banding — but not zero. Fibre, fluids and avoiding straining protect the result.
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Time off work: one to two weeks
Desk work at one week for many; anything physical closer to two to three. Driving when you can perform an emergency stop without wincing.
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Red flags
Heavy fresh bleeding, fever with pelvic pain, or inability to pass urine after the catheter is out — call the clinic or A&E the same day.
Reading your operation note
Your operation note in four parts. Read the last one first.
Whichever technique was used, the note the surgeon sends you keeps to the same shape.
A quiet reminder
Surgical language is precise and can read coldly — we translate it for you.
If you would like us to talk you through the note before your review, just ask.
- 01 Header
Indication and grade
Why the operation was done — Grade III–IV disease, failed HAL, mixed internal-external — and which technique was agreed with you.
- 02 Technique
Anaesthetic and surgical technique
Whether it was Milligan-Morgan, Ferguson, LigaSure or laser; the anaesthetic used; and which cushions were excised.
- 03 Findings
Additional findings
Notes on the anal canal — fissure, sentinel tag, sphincter tone — and anything sent to histology.
- 04 Impression
Recovery, analgesia, and review timing
Read this first: what to expect for the first two weeks, the analgesia plan, and when to be seen again.
Recognised by major UK insurers
Cover for haemorrhoidectomy is standard when medically indicated — we confirm authorisation and any excess before booking.
Frequently asked
Everything we get asked about haemorrhoidectomy.
Quick answers on pain, cost, alternatives, and how much time off work you actually need.
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Why would I need a haemorrhoidectomy rather than banding or HAL?
Excisional haemorrhoidectomy is the definitive operation for Grade III–IV piles, for mixed internal and external disease with thrombosed external components, and after failed banding or HAL. It has the highest durable cure rate — over 90% at five years — but also the most difficult recovery.
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How painful is a haemorrhoidectomy afterwards, honestly?
Significant pain for the first ten to fourteen days is expected — this is the main reason patients hesitate. A proper regimen of paracetamol, an NSAID, a weak opioid, lactulose and a topical GTN or diltiazem makes it manageable but not invisible.
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What is the difference between Milligan-Morgan and Ferguson?
Both excise the three haemorrhoidal cushions and ligate the pedicles. In Milligan-Morgan (the UK gold standard) the wounds are left open to heal. In Ferguson (more common in the US) the mucosa is closed with a running suture. Outcomes are broadly similar.
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Is stapled haemorrhoidopexy (PPH) still offered in the UK?
It is rarely offered now. ACPGBI reviewed the data after high-quality RCTs showed a higher rate of recurrent prolapse and a small but serious rate of complications — chronic pain, sepsis, and rectovaginal fistula in women. Most UK colorectal surgeons have moved away from it.
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What about LigaSure or laser haemorrhoidoplasty?
LigaSure and Harmonic energy-device excision reduce blood loss and, in trials, first-week pain. Laser haemorrhoidoplasty (LHP) shrinks the tissue from within with a diode laser and has less post-operative pain, but the durability evidence is still maturing.
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How much does a private haemorrhoidectomy cost in London?
Roughly £3,000–£5,000 for Milligan-Morgan or Ferguson, £3,500–£5,500 for LigaSure or Harmonic, and £3,200–£4,800 for laser haemorrhoidoplasty. We confirm a firm figure within one working day.
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How much time off work do I need?
Most patients take one to two weeks. Desk work often resumes at seven to ten days; anything physical, driving or cycling closer to three to four weeks. Return to sport is usually four weeks.
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When should I go to A&E after the operation?
Heavy fresh bleeding — more than a small amount on the pad — fever with pelvic pain, or inability to pass urine after the catheter is out are all reasons to seek same-day medical help.