What Does The Procedure Involve
An enema is usually given an hour or so before the operation to clear the lower part of the bowel. The operation is usually performed under a general anaesthetic. During the operation the blood vessels feeding the haemorrhoids are identified using a special ultrasound probe. These vessels are then sutured to cut off the blood flow to the haemorrhoid.
External skin tags, if present, are not routinely removed but many do shrink in size after the HALO-RAR procedure.
Recovery And Post Op Care After Hal
What To Expect After The Procedure?
First Follow Up Appointment
The first follow-up appointment for a patient after a Hemorrhoidal Artery Ligation is usually scheduled six weeks later, although this schedule is not perpetual and some doctor typically recommends a longer period, so it is important to talk to the doctor before surgery, regarding the follow up.
Haemorrhoidal Arterial Ligation And Rectoanal Repair
HAL-RAR can be considered in two parts the HAL, and the RAR.
HAL stands for haemorrhoidal artery ligation. Under direct vision, or with a miniature ultrasound device, Dr Morris is able to accurately locate the arteries supplying blood to the problematic haemorrhoid.
A stitch is placed around the artery to reduce blood flow, allowing the haemorrhoid to become less engorged, and less prone to bleeding, prolapse and irritation.
HAL-RAR is a better tolerated haemorrhoid operation than haemorrhoidectomy. It avoids the painful wounds, and risk of non-healing and bleeding that can occur with excision. Dr Morris will often discuss this operation with you if there are concerns around incontinence, a history of childbirth, or a history of other anorectal procedures. It is a lesser invasive option for haemorrhoids than the traditional painful treatments.
HAL-RAR for many people can be painless, as most of the repair is performed above the level of nerve supply. However, pain can still occur in the first 1-2 weeks. There can be a sense of irritation or urge from the repaired tissue until the inflammation subsides. Given their is no excision, there may not be improvement to the external component, or skin tags, and the strategy for these will be discussed with Dr Morris to ensure a clear understanding and mutual decision on how to proceed.
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Haemorrhoidal Artery Ligation Operation
Haemorrhoids are a common problem. Many patients can manage their symptoms with attention to diet or a topical treatment when symptoms are minor. For small internal haemorrhoids rubber band ligation can be an effective treatment. For larger haemorrhoids or where simpler treatments havent been effective a Haemorrhoidal Artery Ligation Operation, HALO, may be recommended.
What Happens After The Operation
You may feel uncomfortable after the operation but this is far less than experienced by patients undergoing haemorrhoidectomy. You will have some local anaesthetic injected into the area this will numb the pain for a few hours. The commonest feeling patients describe is a feeling of being kicked in the bottom.
Patients are allowed to eat and drink as soon as they feel able.
Patients should be able to go home on the same day as the operation.
You will be given painkillers to take by mouth you should take these regularly to prevent pain coming on.
It may be a little uncomfortable when you first open your bowels after the operation, it is important that you do not avoid going to the lavatory. Any discomfort will get better. Patients are given a regular stool softener to take for 4-6 weeks and are advised to avoid straining.
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Who Need This Procedure
Why is HAL-RAR Done?
There can be many symptoms that may require you to go through the HAL-RAR procedure here are a few common ones:-
What Are The Risks
There are small risks associated with any operation. Pre-operative assessments are made of any heart or lung conditions, as well as any coexisting medical condition. During the hospital admission patients wear stockings to prevent thrombosis .
Bleeding can occur after any haemorrhoid surgery most patients will notice small amounts of blood, particularly when they open their bowels. Usually this is a small amount but rarely it can be quite a lot, if that occurs patients must seek medical advice.
Infection is very rare if patients develop increasing pain, fevers or flu-like symptoms they should seek medical advice.
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