Dearterialization by THD Doppler method and DG-HAL entails the joining of haemorrhoidal arteries, which has proven successful. Persistent bleeding is not evidenced in most of the patients. Patients undergoing this procedure did not complain of fecal incontinence and every patient reported progress in symptoms after a follow up of between 3 and 17 months.
This procedure was used on patients with bleeding hemorrhoids who failed to respond to office or medical treatment methods. The patients underwent the Distal Doppler-guided dearterization (DDD) with an enema and anesthetic with propofol given as a painkiller in every patient before the procedure. During the operation, breathing was sustained through a laryngeal mask and no antibiotics were administered. Patients were laid in lithotomy positions and only one surgeon carried out the procedure. Using proximal Doppler-guided dearterialization alone could be unsuccessful in identifying the haemorrhoidal arteries at various places because of the possibility of extending further downward below the submucosa, especially the frontal rectal wall. This theory is sustained by the increased number of patients reporting persistent bleeding after proximal Doppler-guided dearterialization was used alone. Therefore, haemorrhoidal treatment using Distal Doppler-guided dearterization (DDD) was found to be an effective and safe method of treatment with bleeding being rare.
Ratto, C., Donisi, L., Parello, A., Litta, F., Zaccone, G., & Simone, V. (2012). Distal Doppler-guided dearterialization is highly effective in treating haemorrhoids by transanal haemorrhoidal dearterialization. Colorectal Disease, 14 (11), ...
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