Haemorrhoidopexy is a technique that involves suturing, but not cutting, the haemorrhoid. It has the advantage of the avoidance of an open surgical wound, and results in less pain than conventional haemorrhoid surgery. Haemorrhoidopexy is suitable for prolapsing internal haemorrhoids (grade I-III), particularly when there is a degree of internal mucosal rectal prolapse. In this procedure the haemorrhoids and associated prolapse are sutured and lifted back up flat within the upper anal canal.
Doppler-guided haemorrhoid artery ligation (HAL)
A doppler-guided haemorrhoid artery ligation (HAL) involves the use of a doppler to identify the arterial vascular pedicle, which is then tied off with a stitch. This reduces blood flow to the haemorrhoid, which over time shrinks the size of the haemorrhoid. It is suited for internal haemorrhoids and has the benefit of being minimally invasive.
Recto anal repair (RAR)
A doppler-guided Recto Anal Repair (RAR) involves that placement of a running suture along the length of the prolapsing haemorrhoid, which is then tied snug, thereby pulling the haemorrhoid back up into the upper anal canal. It usually follows haemorrhoid artery ligation (HAL).