Hemorrhoid banding using videoendoscopic anoscopy and a single-handed ligator: an effective, inexpensive alternative to endoscopic band ligation.

OBJECTIVE: We evaluated a technique of hemorrhoid banding using videoscopic anoscopy and a single-handed ligator that offers substantial cost savings over endoscope-mounted devices.

METHODS: Patients with rectal bleeding from grade II/III hemorrhoids had videoscopic anoscopy, which provided a magnified view, allowing accurate localization of the hemorrhoids and the dentate line before banding, and a photographic record, if required. Banding was performed using a suction ligator that could be operated by one hand, allowing the other to control the anoscope.

RESULTS: Of 39 patients with second- and third-degree hemorrhoids, 34 (87%) had no further bleeding after a single banding session and a further three had no recurrence after a second session. The only complications were pain (one patient) and infection (one patient).

CONCLUSIONS: This method is convenient and effective, costing per procedure less than one-tenth of endoscope-mounted band ligators. We recommend its use in preference if magnified views and a photographic record are required. However, its cost and complexity, compared with traditional hemorrhoid banding, may mean that the latter is preferred in the office setting.