Differences in outcome?  Not everyone needs an operation.  Surgery takes time to heal.  

Her video on how to avoid hemorrhoidal surgery, meaning no need for surgery.  

Fiber video. 

Behavioral modification to avoid surgery. 

It's all

5:35. God gave you 6 hemorrhoidal vessels.

3 of these vessels tend to be the most common pathologic.  So with time these hemorrhoidal column vessels will grow, they'll swell, they'll begin to bleed, they'll begin to prolapse.  That occurs over time so these hemorrhoids have an aging process and so the 3 larger vessels, there are 2 in the right and one in the left, are the most common to be affected there are some patients where all six hemorrhoidal vessels are affected.  The original surgery involves removing basically the three primary vessels.  And we would avoid trying to do all six because that is too much surgery.  That whole surgery involved removing external skin all the way to the inside lining of the rectum, that little column of tissue, and when you do that in three different areas around the bottom, holy smokes, that's hard to heal.  The temptation is, and this is why no offense to my general surgery friends I did not learn this in general surgery, I learned this in colorectal surgery, you really have to be conservative with how much tissue you remove.  The temptation is to remove everything that's swollen in the body, smooth as a baby's ass.  You can't do that because the skin has to stretch, it has to be stretchy, which is why removing 6 of these hemorrhoids is going to be really tough recovery.  I don't think it's going to end well. So we try not to do six incisional hemorrhoids, that is just not going to happen.  Not in trained hands typically.

7:40. So this is my plea to you to find someone who is a colorectal surgeon and not just a general surgeon so that's old fashioned incisional hemorrhoidectomy.  That is very painful.  There are newer techniques that work mostly on the inside where you have less pain fiber. Where are the recovery for those types of surgeries are much shorter.  So the recovery is gauged in one or two weeks as opposed to three to six weeks.  The more you can do on the inside the better.  Which of these surgeries that you were going to get is extremely dependent upon the surgeon you were talking to so that is a question that you should probably ask what is your approach there Doc?. My job is to do the most I can with the least amount of pain to you possible which means if I can avoid external incisions I will if I have to make an external incision can I do it in a way that avoids and incision in the anal Canal itself the part that is under the most tension because if I can I will.

9:50. The recovery process is yours my friend.  That has nothing to do with me my job is technically typically not put tissue under tension to avoid as many painful incisions as I can Improvement of what your complaint is.  The recovery is all on you.  You are not going to be happy if you decide I'm just not going to poop for a week it's not going to hurt it's not so bad and true enough for that first week when you haven't pooped you're right congratulations but now there's a brick that has to come through fresh incisions.  That bricks not going to be coming through there on its own; you're going to have to use stuff to make it come through there.  And then you'll have a brick ripping things and then you're going to have resulting diarrhea that follows that gets into all the incisions and all the stitching and destroys everything and things get burny and irritated and you've just bought yourself a 2 or 3 month recovery instead of a 2-week recovery.  So I know it sound like a great idea to ignore when I'm about to say by not eating after surgery because I have a lot of patience and say, "Oh, I just won't to eat anything." That is just a bad idea.