You will receive an enema an hour or so before your surgery. No special bowel preparation is necessary before HALO-RAR, unless you are also having a colonoscopy in the same sitting. You will have the opportunity to discuss fully all the risks and benefits of this operation with me before signing your consent form. The whole procedure takes about 30 minutes. You will need to fast from midnight on the night before if your surgery is scheduled for the morning, or from 7 am if it scheduled for the afternoon. HALO-RAR is done as a day-stay procedure under general anaesthesia, so you will not feel any pain. This combined approach has the benefits of preserving as much healthy haemorrhoidal tissue as possible while lessening the pain many patients feel after a haemorrhoidectomy. If this is the case, a haemorrhoidectomy can be performed for those haemorrhoids in the same sitting. Sometimes, during the course of this operation, we discover haemorrhoids arising from one or both of the other two haemorrhoidal cushions that are too difficult to treat successfully by HALO-RAR alone.
HALO-RAR has the combined effect of making a large sagging haemorrhoid shrink, drawing the prolapsed haemorrhoidal tissue back up to its correct place inside the rectum, and holding it there. The loose end of the running stitch is then tied to the ligature created earlier during the HALO part of the procedure. This running stitch is then tightened to draw up the lax tissue. A small dissolvable stitch (ligature) is then placed around the vessel feeding the haemorrhoid to seal it off.įor the RAR part, the Doppler probe is removed and a running stitch (plication suture) is placed along the length of the prolapsed haemorrhoid. This vessel lies within the lining of the rectum above the haemorrhoidal cushion. This ultrasound probe is then used to find the exact positions of the vessel (artery) supplying blood to the haemorrhoidal cushion containing the haemorrhoid(s). RAR ( rectoanal repair) is the second part, which fixes the prolapsing part of the haemorrhoid by lifting it up and stitching it back into its normal place in the rectum.įor the HALO part, a narrow plastic tube (proctoscope) with an embedded micro-Doppler ultrasound probe is placed in the anus.
This stops the bleeding and makes the haemorrhoid smaller. HALO (haemorrhoidal artery ligation operation) is the first part, which cuts off the blood supply to the haemorrhoid.
HALO-RAR* is a two-stage open procedure designed to treat internal and external haemorrhoids that are swollen, bleeding and prolapsing, without removing the haemorrhoidal tissue completely by haemorrhoidectomy.
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