Dr. Domingo E. Galliano Jr.,

Dr. Domingo E. Galliano Jr.,


Dr. Galliano is the most experienced Board Certified Colorectal Surgeon with Da Vinci Robotic Surgery in Lee, Charlotte, Sarasota, and De Soto Counties. He has performed over 1600 DaVinci Robotic procedures!

General Surgery

Board Certified by
the American Board of Surgery

Colon and Rectal Surgery

Board Certified by the The American Board of Colon and Renal Surgery (ABCRS)

Surgical Critical Care

Board Certified by The American Board of Surgery


Murdock Surgical Center

Fawcett Memorial Hospital

Bayfront Health

Dr. Galliano is Medical Director of Bayfront Health's Colorectal Center of Excellence.

Why is it important you choose a Board Certified Surgeon?

A surgeon certified in general surgery by the American Board of Surgery has training, knowledge and experience related to the diagnosis and comprehensive management of surgical conditions.

Read more about Board Certified Surgeons

Painless Hemorrhoid Clinic
Office Treatment of Hemorrhoids

Domingo E. Galliano, Jr., MD, FACS, FASCRS
Board Certified in Colon and Rectal Surgery

article on hemorrhoids

Hemorrhoids are rarely a matter of life or death, but they can make some people’s lives seem unbearable due to possible symptoms of pain, itching, swelling, bleeding and protrusions. Symptomatic hemorrhoids are one of the most common complaints a physician evaluates.

You can read this article by Dr. Galliano on In-Office Treatment of Hemorrhoids. Click on image.


The problem is undiscriminating; it can occur in both men and women of any age. Often, hemorrhoids enlarge and become increasingly bothersome with age.

Reports estimate that at least 50% of individuals over the age of 50 have some form of symptomatic hemorrhoids. Many patients try to doctor their own hemorrhoids; they spend over $100 million a year on nonprescription remedies. Many are able to control their problem by increasing the fiber content of their diets, maintaining normal weight and avoiding straining during bowel movements.

Patients who have hemorrhoids that don’t respond to self-care measures should consult a physician. Not all rectal growths are hemorrhoids, and although rectal bleeding is not necessarily a sign of colon cancer, it should be evaluated to rule out the possibility.

Hemorrhoids may be a sensitive subject for most people, but it no longer has to be a painful one. There are now new techniques that can be performed in the privacy of a physician’s office, curing the condition quickly, safely, painlessly, and with no downtime.

HET Systems for Internal Hemorrhoids

The HET System is a new non-surgical device for the treatment of internal hemorrhoids. It is based on well-established scientific principles, gentle, simple and well-tolerated. The technology is cleared for use by FDA and European authorities.

The hemorrhoids are treated with a unique ligation technology, resulting in their shrinkage and subsequent resolution of the disturbing symptoms. It is a gentle, simple technique and easy to use in the ambulatory setting.

The procedure using the HET System is usually very well-tolerated and patients experience either no pain, or brief, mild discomfort. Typically, patients may return to work and normal activities right after the procedure.

For more information on HET Systems, click here.

THD Procedure for Hemorrhoids

A Minimally Invasive Procedure

The THD procedure offers a minimally invasive surgical approach to treating the source of the hemorrhoids. And, because there is no surgical removal of tissue, there is minimal post-operative pain. THD (Transanal Hemorrhoidal Dearterialization) is offered as an out patient procedure which gets you back to normal activities quickly.

THD uses a doppler to locate the terminating branches of the hemorrhoidal arteries. Once the artery is located the surgeon uses an absorbable suture to ligate or “tie-off” the arterial blood flow. The venous “out flow” remains to “shrink” the cushion. This is done without excision of tissue. If necessary the surgeon will perform a hemorrhoidopexy to repair the prolapse. Again, this is done with suture and no excision of tissue. This repair restores and “lifts” the tissue back to its anatomical position.

The entire procedure is performed above the dentate line so that there is minimal discomfort. The procedure takes about 20 minutes and is offered as an out-patient surgery.

Lean more about the procedure by watching our videos.

colonOther non-surgical options

Fast gaining popularity among surgeons and the patients they treat with this new method, Infrared Coagulation is an offshoot of laser technology.

In some cases, doctors prefer another innovative treatment method called rubber band ligation. Hemorrhoids, also known as piles, are masses of dilated veins in the anus or in the mucous membrane of the rectum,” explains Domingo E. Galliano, Jr., MD. “Among factors contributing to this condition are heredity, nutrition, occupation, pregnancy, exercise, coughing and constipation.

Hemorrhoids are rated in severity by four degrees, and classified as external or internal by their location. The extent of the disorder determines the treatment.

Lesser hemorrhoids may require no treatment but more extensive ones may need surgery. There is, however, a large group of people who have moderately severe hemorrhoids. They can be treated in an office setting using gentle, effective, non-surgical methods such as rubber band ligation and a new method called Infrared Coagulation.

“The treatment is virtually pain-free and requires no anesthesia. Some patients report feeling a brief sensation of heat during the treatment. Patients are saved the expense of hospitalization, and they typically only need two or three office treatments lasting about 15 minutes each.

The most likely candidates for IRC are those patients who have bleeding internal hemorrhoids, prolapsing internal hemorrhoids and small external hemorrhoids.” Since its government approval in 1984, IRC has been used successfully by over 10,000 physicians in the United States.

Physicians praise it as a procedure that does not provoke bleeding or require sutures, but reduces infection risk and allows patients to return to normal activity immediately after treatment. In 90-95% of patients treated with IRC, their problem is cured with no recurrence of growth in the same site.

No downtime

In both the IRC and rubber band ligation procedures, patients can return home with little or no discomfort after treatment, and they do not have to miss a day of work. In some cases, doctors prefer another innovative treatment method called rubber band ligation.

“This procedure is especially effective for second degree hemorrhoids, which are those that protrude at defecation but contract spontaneously,” notes Dr. Galliano. “Third degree hemorrhoids, which protrude but must be replaced manually to their original position, also respond well to rubber band ligation.”

Another non-surgical method for the removal of hemorrhoids, rubber band ligation involves a tiny flexible band, which is placed around the pile, where it tightens, depleting the blood supply to the area. Deprived of blood, the growth shrinks. In only one or two office treatments, the troubling condition is resolved.

Fast gaining popularity among surgeons and the patients they treat with this new method, Infrared Coagulation is an offshoot of laser technology.

“With the use of an Infrared Coagulator (IRC), we can zap away hemorrhoids by using a pistol-like probe that emits bursts of infrared light energy lasting between 1.5 and 2 seconds each,” describes Dr. Galliano. “This pulsed light causes the blood within the knot of hemorrhoidal tissue to clot. The hemorrhoid then shrivels up and dies".

Other methods for treating hemorrhoids include sclerosing injections and cryotherapy. In cases in which very large internal and external hemorrhoids exist, a hemorrhoidectomy may be the best option. A physician experienced in all treatment methods can serve as a knowing guide in making these decisions.

“There is no single treatment for all hemorrhoids; the physician must evaluate each patient individually,” concludes Dr. Galliano. “The good news is, with the advances in modern medicine, we can offer more comfortable, less-invasive treatments for a variety of hemorrhoid conditions. An office visit to your physician may produce a new, simpler, non-surgical answer to a very old and common problem."