LigaSure is a bipolar energy device used to divide tissue and seal vessels during haemorrhoid removal. It is a tool for performing an excisional haemorrhoidectomy, not a laser treatment. At consultation, we first assess whether removal is appropriate, then discuss the technique and extent of surgery.
Who may benefit
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Excisional surgery may be considered for a substantial external component, troublesome combined internal and external haemorrhoids, significant prolapse or symptoms that persist despite suitable previous treatment. Grade III or IV internal haemorrhoids are relevant findings, but the grade alone does not replace examination. Bleeding, discomfort, hygiene problems, other health conditions and the patient's priorities all matter.
Small haemorrhoids without significant symptoms do not require surgery merely because they are present. Bowel habit changes or an outpatient procedure may be sufficient in some cases. A thrombosed external haemorrhoid needs a separate assessment based on symptoms and their course.
How the procedures differ
During haemorrhoidectomy, the surgeon removes affected tissue and controls bleeding. LigaSure supports these steps with controlled bipolar energy. HAL-RAR aims to reduce the blood supply to internal haemorrhoids and address prolapse. Laser haemorrhoidoplasty acts on haemorrhoidal tissue differently. These approaches are not interchangeable for every patient.
A modern device does not mean there will be no wound or no postoperative pain. The result also depends on anatomy, the amount of tissue removed, surgical technique and aftercare. We explain which problem the proposed operation addresses and which symptoms may have another cause.
Before surgery
Bring a list of medicines and allergies and tell us about previous operations or existing problems controlling wind or stool. Do not stop anticoagulants or antiplatelet medicines yourself. Tests, bowel preparation and fasting instructions are tailored to the planned operation and anaesthetic. Do not start a full bowel-cleansing preparation without instructions.
We discuss anaesthesia with the anaesthetist and clarify the cost of the procedure, disposable equipment, anaesthesia, hospital stay and follow-up. Current figures are listed on the prices page; the final estimate depends on the agreed treatment plan.
Recovery and possible complications
Pain during bowel movements, swelling and small amounts of blood can occur after removal. Recovery requires appropriate pain relief, soft stools and assessment of wound healing. Possible complications include bleeding, urinary retention, infection, narrowing of the anal canal and changes in continence. We discuss these without promising a risk-free outcome.
Heavy bleeding, fainting, increasing pain with fever or inability to pass urine require urgent medical assessment. Returning to work and exercise depends on recovery and the demands of the activity rather than a fixed timetable for everyone.
Questions to bring
Ask why excisional surgery is recommended, which alternatives are reasonable and whether the external component will be removed. Agree on follow-up and how to contact the department after discharge. A clear plan makes it easier to prepare and report any concerns promptly.
Sources
Information from the centre’s team. An individual treatment plan requires assessment.