Haemorrhoidectomy

What Is Rubber Band Ligation?

Rubber band ligation is a minimally invasive procedure used to treat internal haemorrhoids. It involves placing a small rubber band around the base of the haemorrhoid to cut off its blood supply. Within 7 to 10 days, the haemorrhoids shrink, dry up, and fall off naturally during normal bowel movement.

What Are the Different Types of Rubber Band Ligation?

There are two main types of haemorrhoid banding. These include:

• Traditional Rubber Band Ligation

  In this traditional method, a doctor uses metal forceps to place a rubber band around the haemorrhoid. This may cause post-procedure pain and bleeding in some patients. It usually takes 5 to 10 minutes but recovery may require up to three days.

• Endoscopic Banding

  This technique uses an endoscope (a flexible tube with a camera) for a direct and magnified view of the haemorrhoids. The better visualisation allows doctors to place bands at the precise location of the haemorrhoid, minimising any potential discomfort or injury. However, it is more complex than other types of ligation, requiring more preparation time before the procedure.

How Do I Prepare for Rubber Band Ligation?

To properly prepare for rubber band ligation, it is essential to follow your doctor's specific instructions. Generally, this includes:

• Medication Adjustment: Inform your doctor about all over-the-counter medications and herbal supplements you currently take. You may be advised to temporarily stop taking certain medications to reduce the risk of complications.
• Bowel Preparation: You may be advised to have a mild bowel prep the night before or on the day of the procedure to ensure your bowels are empty. Maintaining good anal hygiene is also important.
• Fasting: Avoid eating or drinking for several hours before the procedure.
• Recovery Preparation: Arrange for someone to drive you home and potentially stay with you for a day or two following the procedure, as you may experience some discomfort.

Rubber Band Ligation Procedure

Rubber band ligation is a quick, simple outpatient procedure typically performed in a doctor's office.

The process involves the patient lying on their side while a local anaesthetic is administered to reduce discomfort. Next, a doctor inserts an anoscope (a lighted tube) into the rectum to locate the haemorrhoid. A small tool called a ligator is then passed through the anoscope to place one or two tiny rubber bands securely around the base of the haemorrhoid, effectively cutting off its blood supply.

This process is repeated for each identified haemorrhoid before the instruments are gently removed.

What to Expect After Rubber Band Ligation

The procedure usually takes 10 minutes. Afterwards, the patient will receive instructions for care and will be able to go home. Most patients can return to their normal activities on the day of the procedure. However, temporary side effects are common after rubber band ligation. Some mild side effects to expect include:

• Discomfort at the anus
• Difficulty controlling the passage of gas and bowel movements
• Swelling or pain in the abdomen
• Feeling of fullness

These side effects resolve on their own, and the tissue where the haemorrhoid was banded will heal over the next couple of weeks. The procedure effectively addresses grade 1, 2, and 3 internal haemorrhoids, offering long-term relief without surgery.