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Hemorrhoidectomy vs Rubber Band Ligation (Banding) Reviews & Cost Comparison

Posted on 04 April 2018 by

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If you currently have hemorrhoids, I feel for you. I have had hemorrhoids before too. 



What is a Hemorrhoidectomy?

A hemorrhoidectomy is where a hemorrhoid doctor makes some incisions to cut out your hemorrhoid (1). You will be placed under anesthesia and there can be some heavy bleeding post-op.

Sometimes, local anesthesia will be enough and you will be alert and oriented throughout the procedure. 

Other times, you will be placed under general anesthesia. 

The surgery is very painful and many people say that if they knew how bad it was they would have never done it in the first place.

One of the biggest complaints or drawbacks of a hemorrhoidectomy is the intense post-operative pain (2).

The typical recovery time is around 2 weeks but can take longer depending on the size of the hemorrhoid removed and how well you respond to your hemorrhoid surgery.

Just because your hemorrhoid has been removed does not mean it will not come back.

This is the big drawback to a hemorrhoidectomy. It’s very invasive, painful, and may not fix your hemorrhoid for good. 

Plus, it costs more to have a hemorrhoidectomy surgery than to try other methods.

Now, there is a newer type of Hemorrhoidectomy called a PPH, or Stapled Hemorrhoidectomy (3).

This type of hemorrhoidectomy is generally less painful and has shorter recovery times.

A stapling device will cut out the hemorrhoid tissue and also suture together the tissue above and below the hemorrhoid at the same time (4). 

This kind of hemorrhoidectomy is commonly used on Grade 3 and Grade 4 internal prolapsed hemorrhoids.

What is Rubber Band Ligation (Banding)?

Rubber Band Ligation is where a doctor ties a rubber band around your hemorrhoid.

This cuts off the circulation or blood flow and the hemorrhoid eventually the hemorrhoid shrinks (5). 

The doctor will first use a proctoscopy, anoscopy, or endoscpopy to find your hemorrhoid (6).

Then, they will either use forceps or a gentle suction system to get your hemorrhoid in a position to apply the rubber band. 

Once the rubber band is applied, your hemorrhoid will not have any blood flow and will shrink and fall off. 

Depending on the size of the hemorrhoid and how your body responds, you may require up to three office visits to get your rubber band reapplied.

This is the main drawback in my opinion.

Also, Banding can cause some pain during the procedure. The reason being the doctor has to grab your hemorrhoid with forceps.

Then, the application of the tight band will cause further pain. 

That is why a new type of Rubber Band Ligation or banding is receiving great reviews.

The CHR O Regan system uses suction to gently get the hemorrhoid into place when applying the rubber band.

According to the official CRH O’Regan website, patients report pain in less than 1% of their banding procedures.

Hemorrhoidectomy vs Rubber Band Ligation Cost Comparison 

When choosing a medical procedure cost will come into play. A hemorrhoidectomy costs a lot more than Rubber Band Ligation. 

The cost of a Hemorrhoidectomy ranged from $2800 to $5000. On the other hand, the cost of a Rubber Band Ligation procedure ranges from $400 to $1300.

This makes a Rubber Band Ligation procedure much more cost effective in treating hemorrhoids.

Of course, if you have health insurance the cost may not be too much of a factor depending on how much your insurance covers.

However, if you are paying out of pocket a Hemorrhoidectomy can be a lot of money. 

Rubber Band Ligation or Hemorrhoidectomy for Surgery Recovery Time

Rubber Band Ligation has a much shorter recovery time. The average banding recovery period lasts anywhere from 1-3 days.

You can have some light bleeding that lasts 10-14 days. Normally this is not an issue unless you are on blood thinners (7)

Sometimes, you may get prescribed pain medication.

The surgery recovery time for a hemorrhoidectomy can be 10-14 days. You are frequently prescribed pain medication for this surgery.

A meta-analysis done on hemorrhoid nonoperative and operative procedures showed that a "Hemorrhoidectomy was more effective than manual anal dilation and RBL, but more pain and complications. RBL had greater efficacy than IS for treating grade I-III hemorrhoids, with no difference in the complication rate" (8). 

Hemorrhoidectomy and Rubber Band Ligation Length of Surgery Comparison

The length of the surgery for traditional banding is around 10 minutes or less. Banding is really a quick procedure. 

A hemorrhoidectomy, on the other hand, can last up to 90 minutes depending on the size and severity of the hemorrhoid.

There typically aren’t many reported issues during the actual banding procedure. A hemorrhoidectomy can have several complications, including bleeding, sepsis, and other common issues with surgery.

Thus, Rubber Band Ligation is much better in terms of the length of the procedure or surgery.

Hemorrhoidectomy vs Rubber Band Ligation for External Hemorrhoids

Banding is typically only used for internal hemorrhoids. But, sometimes an external hemorrhoid can be treated by banding an internal hemorrhoid. 

This process can get rid of the external hemorrhoid and has a fairly high success rate with the CHR O’Regan system. 

There is a possibility that banding will not be an option for your external hemorrhoid.

In this case, a hemorrhoidectomy or drainage of the hemorrhoid may be your best option. This is typically when you have a large external thrombosed hemorrhoid

Also, some skin tags are reported to be left over when using banding on an internal hemorrhoid to get rid of external hemorrhoids.

The skin tag will then need to be removed.

A hemorrhoidectomy can be used for external hemorrhoids but is recommended in the first 72 hours of onset.

Hemorrhoidectomy vs Rubber Band Ligation for Internal Hemorrhoids 

Rubber Band Ligation is a great option for Grade 1, 2, and 3 internal hemorrhoids. It is not recommended for Grade 4 hemorrhoids. A hemorrhoidectomy can be used to treat Grades 2, 3, and 4 internal hemorrhoids.

Most Grade 1 internal hemorrhoids are asymptomatic and will not require medical treatment.

Hemorrhoidectomy Reviews

Many reviews are mixed regarding the hemorrhoidectomy. While the surgery works about 70% of the time, many people get frustrated at the intense pain and the long recovery time. 

With the advent of technology, there are a few other medical procedures now available that are less invasive, less painful, and require less surgical recovery time. 

The biggest drawback to a hemorrhoidectomy is the INTENSE PAIN.

Rubber Band Ligation Reviews 

Banding, or Rubber Band Ligation as it is also known, has relatively good feedback and reviews. Plus, with new types of Banding (CHR O’Regan), the pain has lessened with this procedure.

The biggest complaint is the pain. However, the pain reported by patients is not nearly as high as the pain reported by patients of a hemorrhoidectomy.

Also, you have to go back to the doctor to get the rubber band applied up to three times if it doesn’t get results initially. 

Many people do report the hemorrhoid “falling off” with just the first rubber band though. 

Hemorrhoidectomy vs Rubber Band Ligation (Banding) Final Review

All in all, the banding procedure is less invasive, painful, and requires a shorter recovery period. However, banding is not recommended for Grade 4 internal hemorrhoids or for external hemorrhoids.

Sometimes, and external hemorrhoid can be treated by banding an internal hemorrhoid, so you can speak with your doctor about that if you have external hemorrhoids. 

A hemorrhoidectomy is an extremely painful surgery for hemorrhoids.

It does have a high success rate, and can be used for both external and internal hemorrhoids, but be warned that the pain can be excruciating.

The pain can be so extreme it is estimated that 20-40% of surgeries require opioids for pain management. 

Overall, Rubber Band Ligation seems to be a better option for internal hemorrhoids. Speak with your doctor to see which is better for you. 

Please note that having a procedure does not guarantee your hemorrhoids will be gone for good. 

Addressing your diet and lifestyle changes can be the best way to prevent future hemorrhoid outbreaks.

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