Hemorrhoidal Artery Ligation

In brief: Hemorrhoidal artery ligation ties arterial branches feeding internal hemorrhoidal cushions, often using Doppler guidance and sometimes adding mucopexy for prolapse.

Use in hemorrhoids

Through an anal instrument, arterial signals may be located and suture ligatures placed above the dentate line. A running mucopexy can lift prolapsing mucosa. Selection depends on the dominant symptom, prolapse pattern, external component, prior treatment, and procedural risks. [1]

Recovery avoids an excisional wound but can still involve pain, bleeding, urgency, urinary difficulty, or temporary activity limits. Infection and other operative complications are uncommon but possible.

Clinical detail

Reducing arterial inflow does not remove external hemorrhoids or guarantee correction of advanced prolapse. Recurrent bleeding or prolapse may require repeat treatment or another operation. A nonexcisional technique is not automatically preferable; anatomy and the balance between recovery and recurrence matter.