Inclusion Criteria:  Informed Consent as documented by signature Hemorrhoidal disease grade II to III unresponsive to medical therapy Age ≥18  Exclusion Criteria:  Inability to follow the procedures of the study, Enrollment of the investigator, his/her family members, employees and other dependent persons, Anesthesiology contraindications to surgery, Emergency situation, Hemorrhoids associated with pregnancy, Oher surgical intervention performed at the same time of the hemorrhoids treatment, Concomitant anorectal disorders (fissure, fistula), thrombosed hemorrhoid, Previous pelvic radiotherapy, previous proctologic intervention during the last three months.