There is some important information about the pre-operative preparation for this procedure. It is imperative that you read this. The HAL-RAR procedure is the ideal procedure for the treatment of symptomatic haemorrhoids that have not responded to conservative management namely optimisation of a high fibre diet and regular bowel habit.
The principle of the operation is to reduce the inflow of blood into the haemorrhoidal plexus by identifying the individual haemorrhoidal arteries using a special Doppler ultrasound probe and ligating it with a suture. All of the haemorrhoidal arteries are located in turn and ligated. In practical terms this is usually six to nine arteries.
The second part of the procedure is to correct the attendant prolapse of the relevant haemorrhoidal sector and this is achieved once again using a plication suture which in the process of tightening reduces the prolapsed mucosa and submucosa into its original position. Whilst the healing process is reasonably quick the long term result is not achieved until approximately twelve week post operatively.
Any medications that are taken routinely should be taken on the day of the procedure with a sip of water unless otherwise specified. Any anti-coagulant therapy should be ceased in accordance with instructions once again issued at the time of booking the procedure. Most procedures are performed as a day case, unless there is a special requirement for an overnight stay or if this is the preference of the patient. The most predominant one is urinary retention. The mechanism is poorly understood.
It is more likely to happen in elderly males who have a degree of prostate enlargement and therefore a predisposition to urinary retention. The nursing staff will ensure that you are able to pass urine freely before discharge. However having achieved this there is the possibility that you may go into retention whilst at home.
