Rubber bands are applied at the apex of (i.e. just above) the haemorrhoidal tissues. The strangulated tissue then becomes necrotic and sloughs off in a few days, after which the wound fibroses, resulting in fixation of the mucosa akin to forming new suspensory ligaments for the anal cushions. The haemorrhoidal tissue is thus prevented from engorging and prolapsing.
This process is relatively painless if the bands are placed above the dentate line, but some patients may experi- ence tenesmus for a day or two that is only partially relieved by analgesia. Banding is usually
- 60–80% effective, depending on proper selection of cases.
Risk
- pain
- retention
- bleeding
- There is a 2–5% risk of secondary haemorrhage.