Hemorrhoidal disease is among the most common anorectal conditions, and rubber band ligation (RBL) is a well-established, minimally invasive office treatment for symptomatic internal hemorrhoids. It works by placing an elastic band at the base of the hemorrhoidal tissue, interrupting blood supply so the tissue sloughs and fibrosis fixes the mucosa.
Device evolution
- Forceps-based ligators require an assistant and grasping of the tissue.
- Suction ligators allow a single operator to capture tissue with negative pressure, improving control and reducing discomfort.
- Multi-band systems deploy several bands in one session without reloading, shortening the procedure.
- Endoscopic banding integrates ligation with visualization for selected cases.
Procedural technique
The internal hemorrhoid is identified through an anoscope, tissue above the dentate line is captured to avoid somatic pain fibers, and one or more bands are deployed at the base. Correct band placement proximal to the dentate line is the single most important determinant of comfort and success. Sessions are typically staged for multiple columns.
Clinical outcomes
RBL provides good symptom control for grade I-III internal hemorrhoids with a favorable safety profile. Common minor effects include a sense of fullness and mild bleeding; serious complications are rare with correct technique. Recurrence can occur over time and may be re-treated. Patient selection excludes patients with significant coagulopathy or immunosuppression from routine banding without added precautions.
INVAMED technologies in this space
INVAMED develops proctology and hemorrhoid-management devices; explore the hemorrhoid and fistula management category.
Device availability and approved indications vary by country. This content is prepared for healthcare professionals and does not replace clinical judgment or the instructions for use.