Rubber band ligation is simple, safe, and effective method performed for first-degree, second-degree, and some cases of third-degree internal haemorrhoids/piles. It is commonly done as an outpatient procedure.
Band ligation may also be considered for bleeding in severely anemic patients with fourth-degree hemorrhoids who are unfit for surgery.
PROCEDURE
A proctoscope/anoscope is inserted into the anal opening, the hemorrhoids are visualized and the most prominent hemorrhoid is addressed first. The hemorrhoid is grasped with an instrument about 1 cm proximal to the dentate line, and a device places a rubber band around the base of the hemorrhoid. This cuts off the blood supply, hemorrhoid then shrinks and dies and, in about a week, falls off.
DURATION
Treatment is limited to 1 to 2 hemorrhoids at a time. Several hemorrhoids may be treated at one time if the person has general anesthesia. Additional areas may be treated at 4- to 6-week intervals.
RECOVERY
Pain may persist for 24 to 48 hours. Regular activities can be resumed in 1-3 days. Heavy lifting or strenuous activities should be avoided for 3–4 days. Bleeding may occur 7 to 10 days after surgery, when the hemorrhoid falls off. Bleeding is usually slight and stops by itself. Sitting in a shallow tub of warm water (sitz bath) for 15 minutes at a time would help relieve discomfort.
RISKS
- Pain.
- Bleeding from the anus.
- Inability to pass urine (urinary retention).
- Infection in the anal area.