Original Article

Outcome of hemorrhoid artery ligation as a novel procedure for hemorrhoidal disease, case series in Shariati hospital of TUMS

Abstract

Background: Hemorrhoidal Artery Ligation and Recto-Anal Repair (HAL-RAR) is a minimally invasive
procedure designed to treat grades III and IV hemorrhoidal disease by addressing both vascular supply and tissue prolapse.
Methods: This study retrospectively evaluated patients undergoing HAL-RAR between January 2024 and
January 2025. Data collected included demographics, disease severity, postoperative pain (Days 1 and 3),
hospital stay, and time to first non-problematic defecation.
Results: A total of 16 patients were included. Postoperative pain was low, with 62.5% reporting no pain on
Day 1 and 88% on Day 3. Median pain scores decreased over time and were not significantly affected by sex.
Defecation function recovered rapidly, with 100% achieving non-problematic defecation within two days
postoperatively. Age showed a non-significant trend toward delayed recovery and slightly increased pain. No
major complications were observed, and all patients were discharged after one night.
Conclusions: HAL-RAR appears to be a safe, well-tolerated, and effective short-term treatment for advanced
hemorrhoidal disease, offering minimal pain and rapid functional recovery. However, larger studies with control
groups and long-term follow-up are required to confirm these findings and evaluate durability.

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SectionOriginal Article(s)
Keywords
Hemorrhoidal Artery Ligation Recto-Anal Repair HAL-RAR Hemorrhoidal Disease Minimally Invasive Surgery Doppler-Guided Surgery
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1.
Dehghani Firoozabadi M, Yaghoubi Notash AYN, Dah Mardeh Ei A, Shahsavand A. Outcome of hemorrhoid artery ligation as a novel procedure for hemorrhoidal disease, case series in Shariati hospital of TUMS. AJS. 2025;8(1):1-5.