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Resorting to removal of hemorrhoids by surgical operation is the only method available in case the hemorrhoid is quite large in size or there are many hemorrhoids difficult to be managed by non-surgical procedure. The surgical procedure for hämorrhiden  is called hemorrhoid-ectomy. The surgical treatment is the choice, when the other treatments have failed. In some of the patients both fixative procedure and hemorrhoidectomy are considered
 
The various Fixative procedures are preferred over hemorrhoidectomy much before the hemorrhoid has become serious enough to plan hemorrhoidectomy of it.  In case the hemorrhoids are very small in size and are protruding out of the anus in the process of hard  bowel movement and is returning back to its original position later on. These are called hemorrhoid of second-degree.
 
On the other hand the hemorrhoidectomy is the rught solution for long term treatment of hemorrhoids. The drawback is it works out much expensive and the recovery period is also much more. It is very painful and carries the risk of the complications.