Latest Innovation in Surgical Management of Haemorrhoids

Abstract

Rama Kant, Kushal Mital and Kamal Gupta

Haemorrhoids are one of the commonest ano rectal problems. Numerous techniques of surgical treatment from old standard Milligan Morgan Haemorrhoidectomy to Non-invasive modalities including IRC, DGHAL RAR(Doppler guided haemorrhoidal arterial ligation and Recto anal repair), MIPH, Radiofrequency to Laser haemorrhoidoplasty. DGHAL was safest but involves substantial basic investment and per case recurring cost of Single use Doppler probes. Thus it was becoming unapproachable to lower middle class and poor patients. Rest other modalities also involve substantial investment and also per case expenditure. Over the experience of over 4,520 procedures by DGHAL equipment we describe same results by DIGITALLY GUIDED HAEMORRHOIDAL ARTERIAL LIGATION (DGHAL) evidenced by use of vascular Doppler confirming artery and stoppage of sound after ligation with hardly any expenditure. This was planned with special reference to Diabetic patients where excisional surgery or even RAR also needed more invasive approach, thus LASER Haemorrhoidoplasty was preferable.

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