Indication: Surgical treatment of hemorrhoidal disease.
TRILOGY is a reusable ultrasound system for detection and surgical treatment of hemorrhoidal disease.
[1] T. Sherif and A. Amin Sarhan, “Doppler-guided hemorrhoidal artery ligation with recto-anal repair versus Milligan Morgan hemorrhoidectomy for grade IV hemorrhoids,” Egypt. J. Surg., vol. 35, no. 3, p. 155, Jul. 2016, doi: 10.4103/1110-1121.189431.
[2] F. C. López et al., “Prospective Randomized Trial Comparing HAL-RAR Versus Excisional Hemorrhoidectomy: Postoperative Pain, Clinical Outcomes, and Quality of Life,” Surg. Innov., vol. 26, no. 3, pp. 1–9, 2019, doi: 10.1177/1553350618822644.
[3] M. DeVos et al., “A retrospective, single-centre analysis on Hemorrhoidal Artery Ligation (HAL) and Recto-Anal Repair (RAR) after ten years,” Ambul. Surg., vol. 25, no. 1, pp. 5–14, 2019.
[4] B. Trilling, A. Mancini, F. Reche, H. Pfl ieger, P. Y. Sage, and J. L. Faucheron, “Assessment of haemorrhoidal artery network using Doppler-guided hemorrhoidal artery ligation for hemorrhoids and pathogenesis implications,” ANZ J. Surg., vol. 89, no. 7, pp. E288–E291, 2019, doi: 10.1111/ans.15143.
[5] H.-U. U. Dorn, “Hemorrhoidal artery ligation/Rectoanal Repair,” Coloproctology, vol. 40, no. 3, pp. 195–203, Jun. 2018, doi: 10.1007/s00053-018-0243-y.
[6] S. R. Brown et al., “Hemorrhoidal artery ligation versus rubber band ligation for the management of symptomatic second-degree and third-degree hemorrhoids (HubBLe): a multicentre, open-label, randomised controlled trial,” Lancet, vol. 388, no. 10042, pp. 356–364, 2016, doi: 10.1016/S0140-6736(16)30584-0.
[7] P. Sirivongs and R. Thiengthiantham, “Short- and Long-term 5-year Clinical Outcomes of Dopplerguided Hemorrhoidal Artery Ligation and Rectoanal Repair,” Vajira Med. J. J. Urban Med., vol. 60, no. 1, pp. 5–14, 2016.
[8] C. Hoyuela et al., “HAL-RAR (Doppler guided hemorrhoid artery ligation with recto-anal repair) is a safe and effective procedure for hemorrhoids. Results of a prospective study after two-years follow-up,” Int. J. Surg., vol. 28, no. February, pp. 39–44, Apr. 2016, doi: 10.1016/j.ijsu.2016.02.030.
[9] R. Yamoul, G. Attolou, N. Njoumi, S. Alkandry, and M. E. H. Tahiri, “The effectiveness of Doppler controlled hemorrhoidal artery ligation based on preliminaries results,” Pan Afr. Med. J., vol. 15, pp. 1–8, 2013, doi: 10.11604/pamj.2013.15.159.2190.
[10] E. Al Zagryadskiy and S. I. Gorelov, “Transanal Doppler-guided Hemorrhoidal Artery Ligation and Recto Anal Repair vs Closed Hemorrhoidectomy for treatment of grade III-IV hemorrhoids. A randomized trial,” Pelviperineology, vol. 30, no. 4, pp. 107–112, 2011.
[11] N. P. Forrest, J. Mullerat, C. Evans, and S. B. Middleton, “Doppler-guided hemorrhoidal artery ligation with recto anal repair: a new technique for the treatment of symptomatic hemorrhoids,” Int. J. Colorectal Dis., vol. 25, no. 10, pp. 1251–1256, Oct. 2010, doi: 10.1007/s00384-010-0951-4.
[12] A. Testa, G. Torino, and A. Gioia, “DG-RAR (Doppler-guided recto-anal repair): a new mini invasive technique in the treatment of prolapsed hemorrhoids (grade III-IV): preliminary report.,” Int. Surg., vol. 95, no. 3, pp. 265–9, 2010, Accessed: Oct. 31, 2019.
[13] G. E. Theodoropoulos et al., “Doppler-guided hemorrhoidal artery ligation, rectoanal repair, sutured hemorrhoidopexy and minimal mucocutaneous excision for grades III-IV hemorrhoids: A multicenter prospective study of safety and effi cacy,” Color. Dis., vol. 12, no. 2, pp. 125–134, Feb. 2010, doi: 10.1111/j.1463-1318.2008.01739.x.
[14] P. M. Wilkerson, M. Strbac, H. Reece-smith, and S. B. Middleton, “Doppler-guided hemorrhoidal artery ligation: Long-term outcome and patient satisfaction,” Color. Dis., vol. 11, no. 4, pp. 394–400, 2009, doi: 10.1111/j.1463-1318.2008.01602.x.
[15] U. Satzinger, W. Feil, and K. Glaser, “Recto Anal Repair (RAR): a viable new treatment option for high-grade hemorrhoids. One year results of a prospective study,” pelviperineology, vol. 28, pp. 37–42, 2009.
[16] J.-L. Faucheron and Y. Gangner, “Doppler-Guided Hemorrhoidal Artery Ligation for the Treatment of Symptomatic Hemorrhoids: Early and Three-Year Follow-up Results in 100 Consecutive Patients,” Dis. Colon Rectum, vol. 51, no. 6, pp. 945–949, Jun. 2008, doi: 10.1007/s10350-008-9201-z.
[17] M. Scheyer, E. Antonietti, G. Rollinger, H. Mall, and S. Arnold, “Doppler-guided hemorrhoidal artery ligation,” Am. J. Surg., vol. 191, no. 1, pp. 89–93, Jan. 2006, doi: 10.1016/j.amjsurg.2005.10.007.
The HAL method is suitable for treating low to medium grade hemorrhoids. The ligation reduces the arterial blood supply, causing the hemorrhoidal cushions to shrink back to normal size.
The RAR method is used to treat the prolapsing hemorrhoids that occur during more advanced stages of the disease. RAR involves one or more mucopexies of prolapsing mucosa carried out after the hemorrhoidal arteries have been ligated.