THE RELUCTANCE of patients and physicians alike to submit to excisional hemorrhoidectomy attests to a general dissatisfaction with this therapy. For many patients the greatest deterrents to surgery are pain, loss of time from work, and expensive hospitalization. The intermittency of hemorrhoidal symptoms allows the patient to procrastinate until the pathology is far advanced, at which time surgery may become imperative.
This study was undertaken to evaluate ligation as a simple method of treatment for prolapsing bleeding internal hemorrhoids. With this technique the main deterrents to surgery may be largely eliminated.
The ligation method of management of internal hemorrhoids was favored by several surgeons in the early 19th century (Salmon1 in 1829); in this method a ligature is placed around the base of an internal pile, allowing the hemorrhoid to infarct and slough out. Excision at the time of ligation was soon practiced as described by Allingham2 in
HICKOK DF, BANICH FE. The Ligation of Prolapsing Bleeding HemorrhoidsA Simplified Approach to a Benign Disease. Arch Surg. 1965;91(3):463-465. doi:10.1001/archsurg.1965.01320150093015