During Hemorrhoidectomy the doctor makes incisions around the anus to cut away the hemorrhoids and gauze packing is inserted to reduce bleeding. Incisions may require stitching, which can cause the area to become tender and painful. Staples may be used in selected cases. It may be performed under a local anesthesia, which numbs the area around the anus, usually combined with intravenous sedation. Alternatively, a regional (spinal or epidural) or general anesthesia may be used.