Hemorrhoids Surgery with the HAL – RAR Technique

Hemorrhoids, when in the initial stage, are treated conservatively by adding plenty of fiber to the diet to facilitate the emptying process. In several cases, the application of conservative treatment can successfully treat the unpleasant symptoms of hemorrhoids that present inflammation and swelling. However, if conservative treatment fails, the HAL-RAR surgical technique is indicated as the preferred hemorrhoids treatment method.

HAL RAR Technique

How is the HAL-RAR method performed?

In the first stage, the individual hemorrhoidal arteries are identified using a special Doppler ultrasound probe, which is inserted into the rectum and then slowly rotated to search for arteries. Once the first artery is found, it is ligated with a suture. The same process is then followed in order to identify further arteries. Once found, each artery is ligated with a suture. The ligatures serve to reduce the arterial blood supply, causing the hemorrhoidal arteries to shrink.

In the second stage of the procedure, the prolapse of the hemorrhoidal tissue is corrected using an injection suture. The suture is placed to elevate the prolapse, forcing the prolapsed mucosa to be pulled back to its original position.

What procedure is followed to treat hemorrhoids with the HAL-RAR technique?

If the patient has been given any medication, on the day of the operation he can take it normally with a sip of water, unless the competent physician decides otherwise. Any treatment with antithrombotic drugs is important to stop. The procedure with the HAL-RAR technique is performed as a day case, unless the physician determines that a hospital stay is necessary or the patient so desires. The procedure is performed under general anesthesia.

What complications does the HAL-RAR method cause postoperatively?

The majority of this technique presents no complications. However, if they do occur, the most common is urinary retention, especially if the patient is elderly and has an enlarged prostate. The specific issue is resolved by the nursing staff without any problem. Another complication that may be observed is the unstable function of her intestine in the first days after the procedure, however this is gradually restored. The occurrence of infection or bleeding is extremely rare.

What results does the HAL-RAR technique offer?

The HAL-RAR technique offers excellent results in the treatment of symptomatic hemorrhoids. The improvement occurs immediately, but the patient fully realizes the benefits of the procedure after about 12 weeks, when the optimal result is achieved. After the operation, pain is to be expected, as the action of the local anesthetic injected locally works for 8 hours. Then, the patient can take oral painkillers. The patient returns home on the same day and can resume his daily activities the very next day. In the first few days after surgery, mild activity and plenty of rest are recommended to give the body time to recover.