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The recurrence rate after excisional hemorrhoidectomy is significantly lower than with any other approach.29 Excisional hemorrhoidectomy can be performed using either an open approach, in which the edges of the mucosal defect are not reapproximated, or a closed approach, in which they are

ESG typically offers faster recovery (35 days), shorter hospital stay, and lower risk of complications

These combined effectsreduced hunger, slower digestion, and improved insulin responsecreate a powerful environment for sustained weight loss without requiring extreme caloric restriction

As GLP-1 access expands across multiple channelsbranded medications, compounded alternatives, and telehealth platformsunderstanding each model's clinical framework, cost implications, and eligibility pathways is essential for informed decision-making