Open haemorrhoidectomy is a commonly performed painful operation. In 1998-99, 26514 haemorrhoidectomies were performed in the UK of which 14373 were day cases. A further 5342 could have been performed as day surgery1. Improvements in multimodal2 and pre-emptive analgesia3, introduction of stapled anopexy4 and improvements in patient counselling5 have led to increasing number of day surgical treatment of haemorrhoids. Technique of LH is described6-11 but with the paucity of randomised controlled trials this is rarely offered as a routine choice to patients with third degree haemorrhoids.