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Safety and Effectiveness of HAL-RAR (Haemorrhoid Arteri Ligation with Recto Anal Repair) With No Doppler Guided Technique on Stage III Internal Haemorrhoid: A Single Operator Experience

Budhi Ida Bagus, Metria Ida Bagus, Setyawati Ida Ayu.

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Background: There were many techniques has been announced to manage internal haemorrhoids, HAL-RAR is a safe and almost painless technique and it has very good results in the control of haemorrhoidal symptoms. This procedure should be considered an effective first treatment option for haemorrhoids. The most common problem which should be discussed was the cost of this procedure, especially in routine clinical practice. We would report the safety and effectiveness of the HAL-RAR with no Doppler-guided on stage III internal haemorrhoid in a single centre teaching hospital.
Case Report: We reported our first 61 patients with grade III internal haemorrhoid managed using a modified HAL-RAR technique without Doppler-guided performed during the procedure. This technique was acceptable well by the patients, pain control could be achieved early in the first post-operative day. The average pain score (using Visual Analog Score) before discharge was 1,77 and the average length of stay was 1,36 days with no post-operative bleeding found during follow up period.
Conclusion: HAL-RAR with no Doppler-guided technique was safe and effective in reducing pain.

Key words: safety, effectiveness, HAL-RAR, Doppler guided, internal haemorrhoid

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