This technique, the Doppler Guided Hemorrhoidal Artery Ligation, is a very innovative treatment for Haemorrhoids. It is mainly used for the 2nd or 3rd degree of haemorrhoids where there is a lots of bleeding and it is predominant. The principle of the technique was to ligate the proximal submucosal haemorrhoidal arteries, thereby reducing the blood flow to the haemorrhoidal cushions and eventually leading to fibrosis and shrinking of the haemorrhoids. This procedure is operated completely above the dentate line, hence it is totally painless.

The HAL Doppler has a handle with a RAR flexi probe. It is introduced in the rectum and then rotated slowly, searching for arteries. The loudest Doppler signal indicates the center of the artery. When the 1st artery is found, it is ligated using an AMI suture. The handle is then turned again to look for further arteries, and the procedure is followed again.

This DG-HAL technique, however is not recommended with those having a grade 4 haemorrhoids, as it is not so successful for that level; and also in some cases for grade 3 haemorrhoids. But otherwise, this technique is highly successful in achieving the desired results. There are no open wounds, minimal pain and the recovery is quick.