World Library  
Flag as Inappropriate
Email this Article

Rubber band ligation

Article Id: WHEBN0000596592
Reproduction Date:

Title: Rubber band ligation  
Author: World Heritage Encyclopedia
Language: English
Subject: Digestive system surgery, Ligation, RBL, Pyloromyotomy, Omentopexy
Collection: Digestive System Surgery
Publisher: World Heritage Encyclopedia

Rubber band ligation

Rubber band ligation
ICD-9-CM 49.45

Rubber band ligation (RBL) is an outpatient treatment for internal hemorrhoids of any grade. There are several different devices a physician may use to perform the procedure, including the traditional metal devices, endoscopic banding, and the CRH O'Regan System which unlike the others, is disposable, painless and 99% effective.[1]

With rubber band ligation, a small band is applied to the base of the hemorrhoid, stopping the blood supply to the hemorrhoidal mass. The hemorrhoid will shrink and die within a few days with shriveled hemorrhoidal tissue and band will falling off during normal bowel movements - likely without the patient noticing.

Rubber band ligation is a popular procedure for the treatment of hemorrhoids, as it involves a much lower risk of pain than surgical treatments of hemorrhoids, as well as a shorter recovery period (if any at all). It is a very effective procedure, and when done with the CRH O’Regan System, it is also associated with a recurrence rate that is only 5% at 2 years.[2] The procedure is typically performed by gastroenterologists, colorectal surgeons, and general surgeons.


  • History 1
  • Procedure 2
  • Complications 3
  • Post-procedure instructions for patients 4
  • References 5
  • External links 6


Ligation of hemorrhoids was first recorded by Hippocrates 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 and refined in 1963 by Barron, who introduced a mechanical, metal device called the Barron ligator (similar to the McGivney).

Dr. Patrick J. O’Regan, a laparoscopic surgeon, invented the disposable CRH O’Regan System. In 1997, the ligator was approved by the FDA for the treatment of hemorrhoids.[3]


Rubber band ligation procedure is as follows:

  1. Pre-treatment diagnosis and prescribed medications
    • Though you may think you have hemorrhoids, a diagnosis is often confirmed by the physician after a colonoscopy, or an anoscopy/proctoscopy is performed.
  2. Preparation
    • Though some procedures may require that the patient fast or take an enema, the CRH O’Regan System requires no preparation of any kind.
  3. Positioning
    • Once ready for treatment, the patient is laid down on the left side on an exam table, with knees drawn up (fetal position).
  4. Application of the band
    • With traditional RBL, a proctoscope is inserted into the anal opening. The hemorrhoid is grasped by forceps 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.
    • The CRH O'Regan ligation system eliminates the use of forceps. The device applies gentle suction which allows the doctor to place a small rubber-band around the base of the hemorrhoid.[4] Three banding sessions are typically required at 2 week intervals for a complete treatment. More bands can be applied if the patient is under general anesthetic, although the recovery time may be prolonged and be more painful.


Possible complications from rubber band ligation include:

  • Pain
  • Bleeding
  • Infection and pelvic sepsis
  • Thrombosed hemorrhoids
  • Non-healing ulcer

Post-procedure instructions for patients

  • In some cases, patients may experience some bleeding, especially after bowel movements, up to 2 weeks after the banding (though this may be from the untreated hemorrhoids as well). This may last for several days or more. If the patient thinks it is severe or persistent (more than one tablespoon of blood), the patient should contact his/her doctor immediately.
  • Paracetamol (Acetaminophen)can be taken for any discomfort the patient may feel (typically a feeling of fullness in the rectum). Ibuprofen should be avoided.[5] A warm bath for about 10 minutes, 2-3 times a day, may help.
  • No heavy lifting or strenuous activities the day of the procedure (and up to 4 days in some cases).
  • 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.
  • In order to avoid constipation, a fiber supplement should be taken daily while increasing water intake to 8 glasses daily (circa 2 liter/ 4 pints).


  1. ^ [1. "Hemorrhoid Treatment with the O’Regan System"] . Retrieved 9 October 2013. 
  2. ^ Cleator, Iain G.M.; Maria M. Cleator (April 2005). "Banding Hemorrhoids using the O’Regan Disposable Bander". U.S. Gastroenterology Review. 
  3. ^ "About Us". Retrieved 9 October 2013. 
  4. ^ "Recovering from Hemorrhoid Banding". CRH Medical Corporation. 8 May 2012. 
  5. ^ 

External links

  • Yale New Haven Health
  • WebMD Health Guide
  • CRH O’Regan System
  • The Long Term Results of Hemorrhoid Banding
This article was sourced from Creative Commons Attribution-ShareAlike License; additional terms may apply. World Heritage Encyclopedia content is assembled from numerous content providers, Open Access Publishing, and in compliance with The Fair Access to Science and Technology Research Act (FASTR), Wikimedia Foundation, Inc., Public Library of Science, The Encyclopedia of Life, Open Book Publishers (OBP), PubMed, U.S. National Library of Medicine, National Center for Biotechnology Information, U.S. National Library of Medicine, National Institutes of Health (NIH), U.S. Department of Health & Human Services, and, which sources content from all federal, state, local, tribal, and territorial government publication portals (.gov, .mil, .edu). Funding for and content contributors is made possible from the U.S. Congress, E-Government Act of 2002.
Crowd sourced content that is contributed to World Heritage Encyclopedia is peer reviewed and edited by our editorial staff to ensure quality scholarly research articles.
By using this site, you agree to the Terms of Use and Privacy Policy. World Heritage Encyclopedia™ is a registered trademark of the World Public Library Association, a non-profit organization.

Copyright © World Library Foundation. All rights reserved. eBooks from Project Gutenberg are sponsored by the World Library Foundation,
a 501c(4) Member's Support Non-Profit Organization, and is NOT affiliated with any governmental agency or department.