DG-RAR (doppler-guided recto-anal repair): A new mini invasive technique in the treatment of prolapsed hemorrhoids (Grade III-IV): Preliminary report

Alessandro Testa, Giovanni Torino, Annarita Gioia

Research output: Contribution to journalArticle

Abstract

Wepresent preliminary data froma prospective observational study on an initial group of 40 patients, selected from our Department, affected by grade III-IV hemorrhoids and treated with a new less invasive technique called Doppler-guided recto-anal repair [DG-RAR; Agency for Medical Innovations GmbH (AMI), Feldkirch, Österreich, Austria]. This study was performed by analyzing bleeding, pain, and prolapse in the preoperative period and after surgery. Follow-up ranged from 5 to 37 months. We used this technique to treat the "vascular factor" with a Doppler-guided suture of the terminal branches of the hemorrhoidal arteries (HAL Doppler), and then we reduced hemorrhoidal prolapse [rectoanal repair (RAR)]. Recto-anal repair was performed with a special proctoscope with an oblique slot that when rotating shows a progressively wider portion of anorectalmucosa and submucosa in a longitudinal direction. Furthermore, this rotation enables the performance of a longitudinal pexy where the prolapse is located. The result is an immediate reduction of hemorrhoidal prolapse. Postoperative follow-up showed disappearance of pain and no bleeding. Relapse of prolapse occurred in 2 (5%) patients. Complications included 2 rectal impactions and 2 cases of thrombosis. The data appear encouraging for grade III-IV hemorrhoids treated with DG-RAR because of reduced trauma and a lower rate of complications with respect to other techniques used for prolapse reduction.

Original languageEnglish
Pages (from-to)265-269
Number of pages5
JournalInternational Surgery
Volume95
Issue number3
Publication statusPublished - Jul 2010

Keywords

  • DG-RAR procedure
  • Hemorrhoidal bleeding
  • Hemorrhoidal prolapsed
  • Hemorrhoids

ASJC Scopus subject areas

  • Surgery

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