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.
Dickey
W
W
Department of Gastroenterology, Altnagelvin Hospital, Londonderry, Northern Ireland, United Kingdom.
Garrett
D
D
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