Treatment of haemorrhoids using the HAL – RAR method

HAL-RAR is an operation for certain forms of internal haemorrhoids. HAL means ligation of the arterial branches feeding the nodes, and RAR means tightening the prolapsed tissue with special sutures if necessary. The method is not a universal treatment for all stages and external nodes. Its benefits, likelihood of recurrent symptoms, and alternatives are compared individually. The promise of a complete cure in one procedure or a fixed result of 96% cannot serve as a guarantee for a specific patient.

Advantages of the technique

Treatment of haemorrhoids can be carried out using conservative, surgical and minimally invasive methods. HAL RAR is a high-tech minimally invasive treatment method and has a number of advantages:

• high efficiency;
• quick result – the effect is achieved in 2-3 days;
• safety for patients of all ages;
• a small number of contraindications;
• pain control (carried out under local anesthesia);
• short recovery period;
• no need for hospital treatment;
• does not leave scars or scars;
• there are almost no complications;
• impacts the cause of the disease, eliminating the possibility of relapse.

To completely get rid of haemorrhoids, one procedure is enough, which lasts 20-30 minutes.

Preparing for HAL RAR

Preparation for surgery begins with examining the patient and identifying possible contraindications. The proctologist prescribes general and biochemical blood and urine tests, and, if necessary, consultation with highly specialized specialists and sigmoidoscopy.

Anticoagulants and antiplatelet agents are discontinued within 3-7 days, while any other medications can be taken even on the day of surgery. For 3-4 days you should exclude gas-forming foods: legumes, potatoes, cabbage, cucumbers, pears, dairy products. Carbonated drinks and juices are prohibited.

On the day of surgery, a cleansing enema, bowel movement, and hygiene procedures are performed. No food is consumed for 10-12 hours before the intervention.

How the procedure works

There are two types of operation:

1. Hal – suturing of haemorrhoidal arteries. Using a special surgical instrument, the surgeon finds and sutures the blood vessels that feed the haemorrhoidal protrusion.
2. Rar – plastic surgery of varicose veins. Using special threads, the lump is pulled to the rectum and securely fixed until necrotization and rejection by the body. Subsequently, they are excreted unnoticed by the patient along with feces.

Separate methods are almost never used; proctologists practice disarterization HAL RAR (nodulation with simultaneous ligation of arteries) to achieve maximum effect.

Stages of manipulation:

1. The patient is placed on a special chair with his legs apart. The area around the anus is treated with antiseptics.
2. An anoscope with a Doppler sensor is inserted into the anus. With its help, the surgeon finds the haemorrhoidal vein and identifies the capillaries that feed it.
3. The proctologist sequentially stitches together all the vessels that feed the haemorrhoid.
4. Once the blood supply is completely cut off, self-absorbing sutures are placed around the venous lump.
5. The sagging area is tightened with the help of sutures, the knot returns to its place, where it gradually becomes necrotic due to the lack of trophism.

HAL-RAR requires a suitable anesthesia plan: depending on the situation, regional or general anesthesia is used, sometimes other options. Anesthesia is needed not only for inserting an anoscope. The statement that the intestines and surrounding tissues do not have nerve endings at all is incorrect. Pain and discomfort are also possible after surgery; discuss in advance ways to control them and what to do if symptoms worsen.

The intervention lasts approximately half an hour, the patient does not require hospital treatment, and after completion of the operation and a short observation he can go home.

Is it worth doing hal rar

HAL-RAR is considered in selected patients with internal haemorrhoids, including prolapsed nodes, when conservative measures are not sufficient. For a pronounced external component or individual cases of severe prolapse, other operations may be preferable. The decision depends on the anatomy, bleeding pattern, previous treatment, and the patient’s expectations. The method can reduce symptoms, but does not promise a permanent cure for everyone. Severe pain requires clarification of the cause, since it is not always caused by internal nodes.

Contraindications:

• malignant neoplasms of the intestine;
• purulent-inflammatory processes in the anal area;
• acute thrombosis of the haemorrhoid.

Age alone does not determine the acceptability of HAL-RAR: general condition, anatomy, comorbidities and anesthetic risks are important. Portability cannot be promised the same to everyone. During pregnancy, the plan of care is agreed upon with the obstetrician and proctologist; Usually they start with conservative measures, and intervention is considered for individual indications.

Rehabilitation after surgery

After the procedure, the patient goes home within 30-60 minutes. Further treatment in a hospital is not required; on the 2-3rd day the patient can return to his normal lifestyle, but it is necessary to follow the doctor’s instructions for 1-4 weeks.

Proctologist’s recommendations for the rehabilitation period:

1. For 14-20 days, heavy physical labor and heavy lifting are prohibited.
2. For a period of up to 1 month, you should avoid public saunas, baths, and swimming pools.
3. Watch your stool and avoid constipation.
4. Take medications prescribed by your doctor: painkillers, anti-inflammatory drugs, laxatives.
5. Avoid fatty, spicy foods, alcoholic and carbonated drinks.
6. Maintain intimate hygiene; in the first weeks after surgery, replace bathing with a shower.

The recovery period is short, there are no relapses of the disease.

HAL-RAR may improve symptoms of internal haemorrhoids in properly selected patients, but results and tolerability vary from person to person. For severe forms of the disease, alternatives including node excision are evaluated. After the intervention, relapse and complications are possible; recovery does not have the same deadline for all ages. Treatment of haemorrhoids is not the prevention of rectal tumors and does not cancel examination for alarming symptoms or routine screening if indicated.