Ten “10” patients with circumferential prolapsed piles were recruited for this pilot study after having the research protocol approved by the ethical committee of scientific research of general surgery department, Faculty of medicine, Ain Shams University. The patients included, should have no other colonic pathologies i.e., their hemorrhoids were not secondary to other diseases e.g., inflammatory bowel disease (Crohn’s), rectal/anal canal carcinoma, being pregnant at the time of the study………This mandated to take thorough medical history and perform complete physical examination including digital rectal examination (DRE) during the office visit or under anesthesia if there was intolerable anal pain (for example due to associated anal fissure) or patient noncompliance during examination. Patients found to have thrombosed piles or associated anal fistulae, were excluded and managed accordingly. Patients with history suggestive of persistent pelvic congestion due to earlier pelvic operations, and those on medications that would affect wound healing (e.g., steroids including long-acting hormonal contraception and immunosuppressant drugs) were, also, excluded. Patients with complete rectal prolapse were excluded. It was decided to exclude patients on prolonged anticoagulation and those with bleeding tendency (their co-morbidities make them more liable to have postoperative bleeding that would not be exclusively, attributed to the studied technique). In our institute, preoperative colonoscopy is not a routine investigation for patients with hemorrhoids unless it is highly indicated for exclusion of other pathologies (e.g., malignancy in old age patients and when there is a high suspicion index for Crohn`s disease). Patients were admitted one day before the operation to have the routine preoperative lab investigations and to be reviewed at the anesthesia preoperative clinic. A fleet enema was done on the night of the operation. A single dose of second generation cephalosporins and metronidazole was given at the time of anesthesia induction. Under anesthesia, whether general or spinal, the patient was put in the lithotomy position. Draping was done and followed by examination under anesthesia (EUA) to slightly dilate the anal verge, deliver the piles, exclude rectal prolapse and other recto-anal pathologies. Excision of the main columns only of the circumferential piles, was done in the usual manner (open Milligan Morgan technique) i.e., A “V- shaped” incision was done around the main piles at 3, 7, and 11 o`clock with low voltage diathermy device after applying two artery forceps at the muco-cutaneous junction and the internal pedicle. This was followed by dissection of the hemorrhoidal columns from the internal sphincter up to the level of their pedicle that would be ligated with a transfixing 2/0 vicryl suture. Consequently, the classic trifoliate clove leaf pattern was obtained leaving residual daughter piles in between. Hemostasis was then assured. For the study group, the needle of a 10-cc syringe was inserted within the residual piles and diathermy was applied to those piles via the inserted needle. It was important to assure the needle was inserted within the hemorrhoidal mass and not transfixing the sphincter complex nor penetrating the internal sphincter. This was achieved by placing the needle while palpating the intersphincteric groove through a Ferguson anal retractor. In case that contractions were noticed within the sphincter complex, the needle would be withdrawn and repositioned more superficially. The wound was then covered with a gauze (it is very unusual at our hospital to perform tight packing for hemorrhoids wounds). Patients were kept on clear fluids till full recovery from anesthesia. After that, the patient was discharged on mild laxative, analgesia, and instructions for appropriate diet (high fibers), sitz bath twice daily for one week, and an appointment at the outpatient clinic (OPC) after one week then weekly for one month. At the OPC visits, patients were examined for bleeding, soiling, and wound infection (in the form of hyperemia, necrosis). The degree of postoperative pain was recorded as severe, tolerable, or absent. During the last follow up visit one month after the operation, DRE was done to determine the anal sphincter tone and any residual or recurrent lesion. The results of our study group were compared to those of the last ten (10) correlated patients from our database as regards the age group and comorbidities.