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Doppler-guided hemorrhoidal artery ligation
Matthias Scheyer1, Elisabeth Antonietti, Gerd Rollinger
1Department of Surgery, Landeskrankenhaus Bludenz, Spitalsgasse 13, A-6700 Bludenz, Austria. scheyer@aon.at
Background:
In 1995, Morinaga reported a new technique for the treatment of hemorrhoids, hemorrhoidal artery ligation (HAL), which uses a specially designed proctoscope coupled with a Doppler transducer for identification and ligation of hemorrhoidal arteries.
Methods:
Because the arteries carrying the blood inflow are ligated, internal pressure of the plexus hemorrhoidalis is decreased.
Results:
We report the results of the first 308 patients (189 male and 119 female; median age 50.1 years) who have been treated at our department since 2002 and followed-up for a median period of 18 months. Eighty-nine patients had grade II, 192 patients had grade III, and 27 patients had grade IV hemorrhoids. The acute symptoms of hemorrhoids were treated immediately by performing HAL.
Conclusions:
Our study showed that HAL is painless, effective, and has a low rate of complications. It can be applied in an outpatient setting and is an good alternative to all other hemorrhoid treatment methods.
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