HAL-RAR (Haemorrhoidal Artery Ligation and Rectoanal Repair)

HAL- RAR ( Haemorrhoid artery ligation & Recto-anal repair)

This technique involve use of Doppler ultrasound device to exactly locate the arteries supplying blood to the piles. Your surgeon then ties off each artery by placing a stitch around it and knotting the ends, hence cutting the blood supply to the pile. This is called Haemorrhoid artery ligation (HAL).

In the case of prolapsing haemorrhoids, your surgeon then runs a stitch from the top to the bottom and pulls the thread. This lifts up the tissue that is hanging down (RAR – Recto anal repair). As a result, over the next few days and weeks the pile shrinks away and the symptoms resolve.

The ligation occurs in the lower rectum, where there are almost no pain nerves. Therefore, your doctor may perform the procedure under mild sedation.

HAL-RAR procedure is an effective option for symptomatic large and prolapsing haemorrhoids tissue. There is no excision and open wound, it is less painful than open haemorrhoidectomy. This results in early recovery from surgery and early rerun to work or activities.

There can be a sense of irritation or urge from the repaired tissue due to inflammation and usually subsides in few weeks. Given there is no excision, there may not be improvement to the external component of haemorrhoids or skin tags.

SELECTIVE STAPLE HAEMORRHOIDECTOMY

Although stapled haemorrhoid surgery has been around for some time, the first generation of staplers were somewhat unsatisfactory sometimes producing less than ideal results.

Using the newer TOUCHSTONE system a stapler is introduced into the rectum and sections of tissue above the haemorrhoids are excised. The technique is 'selective' in that the surgeon decides what areas of tissue are excised, leaving healthy tissue behind and unharmed.

This technique is especially useful for larger troublesome prolapsing haemorrhoids in selected patients. This technique results in minimal pain and discomfort compared to traditional surgery.