Rubber band ligation
Encyclopedia
- Rubberbanding directs here, for the Video Game AI Technique, see Game Artificial IntelligenceGame artificial intelligenceGame artificial intelligence refers to techniques used in computer and video games to produce the illusion of intelligence in the behavior of non-player characters . The techniques used typically draw upon existing methods from the field of artificial intelligence...
Rubber band ligation is an outpatient treatment for second-degree internal hemorrhoid
Hemorrhoid
Hemorrhoids or haemorrhoids , are vascular structures in the anal canal which help with stool control. They become pathological or piles when swollen or inflamed. In their physiological state they act as a cushion composed of arterio-venous channels and connective tissue that aid the passage of...
s.
In this procedure, a small band
Rubber band
A rubber band is a short length of rubber and latex formed in the shape of a loop and is commonly used to hold multiple objects together...
is applied to the base of the hemorrhoid, stopping the blood supply to the hemorrhoidal mass. The hemorrhoid will then shrivel and die within 2 to 7 days. The shriveled hemorrhoid and band will fall off during normal bowel movements.
Rubber band ligation is a popular procedure, as it involves less pain than surgical treatments of hemorrhoids, as well as a shorter recovery period. Its success rate is between 60 and 80%.
History
LigationLigature (medicine)
In surgery or medical procedure, a ligature consists of a piece of thread tied around an anatomical structure, usually a blood vessel or another hollow structure to shut it off. With a blood vessel the surgeon will clamp the vessel perpendicular to the axis of the artery or vein with a hemostat,...
of hemorrhoids was first recorded by Hippocrates
Hippocrates
Hippocrates of Cos or Hippokrates of Kos was an ancient Greek physician of the Age of Pericles , and is considered one of the most outstanding figures in the history of medicine...
in 460 BC, who wrote about using thread to tie off hemorrhoids.
In modern history, ligation using rubber band was introduced in 1958 by Blaisdell
Blaisdell
Blaisdell is a surname and may refer to:*Alfred Blaisdell, politician from North Dakota*Daniel Blaisdell, politician from New Hampshire*James A. Blaisdell, founder of the Claremont Colleges*John Blaisdell Corliss, politician from Michigan...
and refined in 1963 by Barron, who introduced a mechanical device called the Barron ligator.
Procedure
Rubber band ligation procedure is as follows:- Pre-treatment diagnosis and prescribed medications
- After diagnosis of the second-degree hemorrhoid, antibioticAntibioticAn antibacterial is a compound or substance that kills or slows down the growth of bacteria.The term is often used synonymously with the term antibiotic; today, however, with increased knowledge of the causative agents of various infectious diseases, antibiotic has come to denote a broader range of...
s are often prescribed, especially to patients with immune deficiency or other medical conditions. Sometimes, a couple weeks of Mesalamine is prescribed prior to the rubber band ligation procedure.
- After diagnosis of the second-degree hemorrhoid, antibiotic
- Positioning
- The patient is laid down on the left side, with knees drawn up and buttocks projecting over the operating table.
- Application of the band
- A proctoscope is inserted into the anal opening. The hemorrhoid is grasped by forcepsForcepsForceps or forcipes are a handheld, hinged instrument used for grasping and holding objects. Forceps are used when fingers are too large to grasp small objects or when many objects need to be held at one time while the hands are used to perform a task. The term 'forceps' is used almost exclusively...
and maneuvered into the cylindrical opening of the ligator. The ligator is then pushed up against the base of the hemorrhoid, and the rubber band is applied.
- A proctoscope is inserted into the anal opening. The hemorrhoid is grasped by forceps
Complications
Possible complications from rubber band ligation include:- Pain
- Bleeding
- Band slippage or breakage
- Infection and pelvic sepsisSepsisSepsis is a potentially deadly medical condition that is characterized by a whole-body inflammatory state and the presence of a known or suspected infection. The body may develop this inflammatory response by the immune system to microbes in the blood, urine, lungs, skin, or other tissues...
- ThrombosedThrombosisThrombosis is the formation of a blood clot inside a blood vessel, obstructing the flow of blood through the circulatory system. When a blood vessel is injured, the body uses platelets and fibrin to form a blood clot to prevent blood loss...
hemorrhoids - Anal fissureAnal fissureAn anal fissure is a break or tear in the skin of the anal canal. Anal fissures may be noticed by bright red anal bleeding on the toilet paper, sometimes in the toilet. If acute they may cause severe periodic pain after defecation but with chronic fissures pain intensity is often less...
Post-procedure instructions for patients
- Patient may experience some bleeding, especially after bowel movements. This may last for several days or more. If the patient thinks it is severe or persistent, the patient should contact his/her doctor.
- Patient should not take aspirinAspirinAspirin , also known as acetylsalicylic acid , is a salicylate drug, often used as an analgesic to relieve minor aches and pains, as an antipyretic to reduce fever, and as an anti-inflammatory medication. It was discovered by Arthur Eichengrun, a chemist with the German company Bayer...
or anything containing aspirin for at least 14 days. - Acetaminophen or IbuprofenIbuprofenIbuprofen is a nonsteroidal anti-inflammatory drug used for relief of symptoms of arthritis, fever, as an analgesic , especially where there is an inflammatory component, and dysmenorrhea....
could be taken for any discomfort the patient may feel. A warm bath for about 10 minutes, 2-3 times a day, may help. - No heavy lifting or strenuous activities for 3–4 days.
- A stool softener such as Surfak is recommended once a day for about 3 days. Stool softeners are available over the counter at any drug store.
- Patient should avoid straining to have a bowel movement. If patient does not succeed at first, he/she should try getting in a warm bath for about 10 minutes.