Hemorrhoid banding using videoendoscopic anoscopy and a single-handed ligator: an effective, inexpensive alternative to endoscopic band ligation.
OBJECTIVE
We evaluated a technique of hemorrhoid banding using videoscopic anoscopy and a single-handed ligator that offers substantial cost savings over endoscope-mounted devices.


METHODS
Patients with rectal bleeding from grade II/III hemorrhoids had videoscopic anoscopy, which provided a magnified view, allowing accurate localization of the hemorrhoids and the dentate line before banding, and a photographic record, if required. Banding was performed using a suction ligator that could be operated by one hand, allowing the other to control the anoscope.


RESULTS
Of 39 patients with second- and third-degree hemorrhoids, 34 (87%) had no further bleeding after a single banding session and a further three had no recurrence after a second session. The only complications were pain (one patient) and infection (one patient).


CONCLUSIONS
This method is convenient and effective, costing per procedure less than one-tenth of endoscope-mounted band ligators. We recommend its use in preference if magnified views and a photographic record are required. However, its cost and complexity, compared with traditional hemorrhoid banding, may mean that the latter is preferred in the office setting.
Department of Gastroenterology, Altnagelvin Hospital, Londonderry, Northern Ireland, United Kingdom.
W
W
Dickey
D
D
Garrett
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003365:Costs and Cost Analysis; D004867:Equipment Design; D005260:Female; D006484:Hemorrhoids / Q000628:therapy*; D006801:Humans; D008026:Ligation / Q000191:economics / Q000295:instrumentation; D008297:Male; D008875:Middle Aged; D011351:Proctoscopy / Q000191:economics* / Q000379:methods; D014741:Video Recording