Gastroenterology Book

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Hemorrhoid BandingAka: Rubber Band ligation, Baron Ligation

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  1. See Also
    1. Internal Hemorrhoid
  2. Indications
    1. Grades I to IV Internal Hemorrhoid
  3. General
    1. Device Cost: $200-300
  4. Adverse effects
    1. Perineal Sepsis risk! (Deaths have occurred)
      1. Rectal Pain
      2. Fever
      3. Inability to void
      4. Reference
        1. Russell (1989) Dis Colon Rect 28:291
    2. Rectal discharge may be a problem
    3. Needs 2 people to perform
  5. Technique
    1. Place 2 rubber bands on ligator over top of cone
      1. Lubricate cone and bands with soapy water
    2. Position Anoscope for good visualization of Hemorrhoid
      1. Confirm not below Dentate Line (External Hemorrhoid)
    3. Insert ligator and pull Hemorrhoid through channel
      1. Be careful not to pull too much
    4. Release bands
    5. Only treat 1-2 Hemorrhoids per visit
    6. Additional bands can be placed in 4-6 weeks
  6. Efficacy
    1. Long term: 40-50% are completely free of symptoms

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