Rubber band ligation or hemorrhoid banding is a very old hemorrhoid treatment. It
has been around since the days of Hippocrates – at least.
In 400 BC, he wrote a treatise “On Hemorrhoids” and discussed treatments of hemorrhoids.
He noted that hemorrhoids could be treated with “cutting, excising, sewing, binding,
applying putrefacient means to the anus.” By binding, he meant the same type of procedure
that is handled with rubber band ligation.
This is a relatively simple procedure where an external hemorrhoid is tied off by
a rubber band that is about 2.5 mm thick and 1mm in circumference. The banding procedure
cuts off the blood supply to the hemorrhoid. This dries out the bulging vein, or
hemorrhoid. The tissue will die and the plan is to have it then fall off, like a
This is how rubber band ligation is carried out. First of all, it is a day surgery
task. The person is positioned on his or her left side with knees pulled up towards
the chest in a fetal position.
The person is covered up except for the area being worked on. Typically the patient
is given an enema first to clean out the anal canal. With a proctoscope, the doctor
can look inside the patient’s rectum to see the hemorrhoids in the anal canal.
A ligator device is lined up with the hemorrhoid to be bound and using forceps, a
small rubber band is placed around the bottom of the hemorrhoidal vein. That is all
there is to the procedure. The person can then go home and wait for the vein to dry
up and be discharged. It takes about a week to 10 days for the vein to shrivel up.
In Hippocrates’ day the procedure was painful and remained so over the years. About
the best that could be said for it was that did not cause bleeding. In 1963, the
Barron ligature came into use and it was a much less painful procedure. The Barron
ligature was made of two concentric barrels connected together by a shaft.
The outer barrel was moved over the inner barrel and thus the rubber band was slipped
over the hemorrhoid. Improvements such as the McGiveny ligature improved on this
and the hemorrhoid was pulled into the inner barrel with a vacuum effect.
Rubber band ligation is considered to be a very successful method of dealing with
hemorrhoids. There are only a couple of things to be aware of.
After the procedure, you might feel uncomfortable but the pain should not be too
intense or too sharp. If it is, the rubber band might be in the wrong place such
as too close to the skin rather than right at the base of the hemorrhoid.
The other problem is that some people want to have the whole hemorrhoid issue handled
at once and too many hemorrhoids are banded at once. This can cause the area to swell
and this can create a problem with bowel movements.
Another downside is that this method does not ensure that the hemorrhoids will not