From the Guidelines
Hemorrhoid banding procedures can be performed in a doctor's office setting. This is based on the evidence from the American Gastroenterological Association technical review on the diagnosis and treatment of hemorrhoids 1. The procedure, also known as rubber band ligation, relies on the tight encirclement of redundant mucosa, connective tissue, and blood vessels in the hemorrhoidal complex.
Key Points to Consider
- The procedure can be performed with one of several commercially available instruments, including devices that use suction to draw the redundant tissue into the applicator, making it a one-person effort 1.
- No anesthesia is required, and the resulting scar fixes the connective tissue to the rectal wall and resolves the prolapse 1.
- Rubber band ligation is most commonly used for first-, second-, or third-degree hemorrhoids, and success rates vary depending on the degree of hemorrhoids treated, length of follow-up, and criteria for success 1.
Potential Complications and Considerations
- The most common complication of rubber band ligation is pain, which is reported in 5%–60% of treated patients, but can be managed with sitz baths and over-the-counter analgesics 1.
- Other complications, such as abscess, urinary retention, band slippage, prolapse, and thrombosis of adjacent hemorrhoids, and minor bleeding from the ulcer, occur in 5% of patients 1.
- Severe bleeding occasionally requires intervention when the eschar from the band sloughs, usually 1–2 weeks after treatment, and necrotizing pelvic sepsis is a rare complication of rubber band ligation 1.
From the Research
Hemorrhoid Banding Procedure
- The hemorrhoid banding procedure, also known as rubber band ligation, is a common treatment for symptomatic hemorrhoids 2.
- This procedure can be performed in an office setting, and it is often used to treat internal hemorrhoids 3.
- The procedure involves the use of a rubber band to cut off the blood supply to the hemorrhoid, causing it to fall off within a few days 4.
Office-Based Treatment
- Office-based treatment of grades I to III internal hemorrhoids with rubber band ligation is a preferred next step after medical management and dietary modifications 3.
- This procedure has a lower failure rate than infrared photocoagulation and is often performed in an office setting 3.
- Local anesthesia can be used to reduce patient discomfort during the procedure, and it has been shown to be safe and effective 2, 5, 6.
Safety and Efficacy
- Studies have shown that hemorrhoid banding procedures can be performed safely and effectively in an office setting, with minimal complications 2, 3, 5, 6.
- The use of local anesthesia and intravenous sedation can help to reduce patient discomfort and anxiety during the procedure 5, 6.
- The procedure is often quick, with a mean procedure time of 12 minutes, and patients can be discharged home the same day 6.