Ligation of the hemorrhoidal node with latex rings - indications and possible complications

Hemorrhoids are a fairly common disease requiring immediate treatment to prevent more serious health problems( anemia, thrombosis and necrosis of hemorrhoids).

There are many ways of treating this disease, however, not all are shown in the later stages. Today we will consider one of the methods - ligation of hemorrhoids with latex rings.

The minimally invasive technique consists of the that the specialist uses a special equipment( endoscopic ligator) to put on the hemorrhoidal knot a latex ring that clamps it.

As a consequence, the blood supply to the node stops, its fading and rejection gradually. The procedure for performing the procedure takes little time, is performed both on an outpatient basis and permanently.

Contraindications to procedure

In this method of treatment there are some contraindications to carrying out:

• diseases of blood coagulation system;
• cracks in the anal passage( temporary contraindication);
• presence of combined hemorrhoids( nodes are located both outside and inside the anal passage);
• inflammatory process( chronic or acute) of pararectal tissue - paraproctitis;
• early, first, stage of hemorrhoids( weakly expressed nodes).

Features of procedure

Ligation of the hemorrhoidal node is usually performed in patients who suffer from stage 2 or 3 disease.

This treatment method assumes two types of doping - vacuum and mechanical.

Ligation is performed on a special chair( gynecological), the legs are pulled up to the stomach.

The anoscope is inserted into the lower end of the rectum, the opening of which is led to the node.

When using a mechanical ligator, the hemorrhoidal assembly with forceps with a soft clamp is pulled into its cylinder and, by pressing a special mechanism, a ring of latex is dropped onto the node's leg.

The feature of using a mechanical device is that the procedure must be performed with an assistant.

When using the vacuum ligator , the head of the device with two rings is applied to the node through the anoscope.

In the ligator, a negative pressure( not less than 0.4 atmospheres) is created by sucking, and the hemorrhoidal node is drawn into it. Then, the rings are dropped onto the leg of the unit, the pressure is equalized and the unit is released by the device.

The use of this method allowed reducing the treatment procedure to 20 minutes without anesthesia( local anesthesia is possible) and with the least pain effect of the subsequent recovery period.

Approximately on the third day after ligation, the tissue of the node dies and it leaves the body in a short time( up to 4 days).On the place of the fallen off node with connective tissues a scar is formed.

Studies show that the procedure is well tolerated by patients.

Rings are made of natural material and behave inertly in relation to body tissues. The subsequent procedure for removing other nodes can be done somewhere in 3 or 4 weeks.

Postoperative medical treatment

Ligation of hemorrhoids by latex rings is performed on an outpatient basis.

After this, the patient is recommended to rest for a day( to avoid possible complications if the patient has "sedentary" or work-related work).

Medical treatment after the procedure is issued by the attending physician and includes in itself:

• taking analgesics to eliminate a small pain effect( 2-4 days);
• anticoagulants( about 5 days);
• laxatives( up to a month);
• use of rectal suppositories that have anti-inflammatory and reduces the risk of secondary infection by actions( after feces and water procedures, up to 4 weeks).

For the next 4-5 weeks, the patient is recommended to adhere to dietary nutrition. Dishes should be light, with a sufficient amount of fiber, not causing meteorisms.

To exclude fatty, spicy dishes, alcohol. To eat it is desirable more often than usual( up to six times a day), but in small portions.

Possible complications of

Latexation with latex rings is fairly gentle, however, there are also complications when performing it:

1. One of those is profuse bleeding .It can occur immediately after the end of the treatment or in a week or one and a half, with the rejection of the latex ring. In this case, the patient is shown an immediate address to the doctor, tk.there may be a need for surgical intervention to stop bleeding.
2. Sometimes after the procedure the pain intensifies and becomes intolerable .If taking analgesics did not remove after 24 hours, other painful effect - you also need to see a doctor. Perhaps the procedure is not correct and there is a need to remove the latex ring.
3. To possible complications, the rally of the ligation ring also applies. This is possible both in case of patient's violation of the postoperative regimen, and with insufficiently precise manipulation.
4. Very rarely( up to 0.05% of cases) thrombosis of nodes( both external hemorrhoidal and internal) can occur. In this case, urgent hospitalization and surgical intervention becomes the solution to the problem.

Testimonials of Doctors and Patients

We study the responses of patients who were ligated to the hemorrhoidal node and the opinion of doctors about the procedure.

Cost of procedure in Russia

The price of the procedure depends on the region, the medical institution( clinic) and the number of sites to be removed. On average, this method of treatment costs from 3500 to 7000 rubles per node.