The latest technology for treating hemorrhoids. Dr. Abdullah Alkadour, MedLife: “I had amazed patients that they left home without pain”
For many patients, the idea of an operation of hemorrhoids is synonymous with pain and discomfort, which feeds fear and numerous prejudices. But modern, minimally invasive surgical techniques-such as Hal-rary-radically change this perception. Recently used in Romania by Dr. Abdullah Alkadour within MedLife Medical Parkthe procedure is safe, efficient and associated with a speedy recovery, a low complications rate and a reduced incidence of relapses. “For me, it is a great professional satisfaction to be able to provide an effective, high -pain, painless, recovery and fast social reintegration,” says Dr. Alkadour, general surgery specialist, doctor in medical sciences and proctologist.
Although there are no precise epidemiological studies on the incidence of hemorrhoid disease, it is certain that this condition is one of the most common problems for which patients reach the proctologist. Hemorrhoids affect up to 50% of the adult population at a time in life, and European studies estimate a prevalence between 11% and 39% among adults.
For advanced forms – hemorrhoids of grade III and IV (according to Goligher classification) – traditional treatment involves excisional hemoroidectomy, an effective surgical procedure, but which can be painful and difficult to bear. “Classic interventions involve excision, which can cause intense postoperative pain and risks of complications such as infections or bleeding,” explains Dr. Alkadour. Excisional interventions are also associated with long -term risks, such as incontinence or anal stenosis, according to specialized literature.
In order to avoid these complications and to meet the need for patients with milder solutions, Halrahoidal Artery Ligation-Recto Anal Repair) has been perfected in recent years in international coloproctology centers.
What is hal-rar and how it works
Unlike classical excisional surgery, Hal-rar does not involve excision and does not affect the sensitive structures of the anal canal. In the first stage – Hal, the doctor uses a special Doppler guidance device that precisely locates the arteries that supply the hemoroid pack. These vessels are then selectively ligated. The second stage – rarely – consists in lifting and repositioning the affected tissue inside the anal canal, where it is.
“What is truly different about Hal-Rara is that we do not remove anything, we do not destroy tissues, we do not make incisions. We reposition what has been moved and we interrupt the blood supply of the dilated vessels. The device shows us exactly where the artery that feeds the hemoroidal package, and the lifting we do after that,” explains everything.
The intervention lasts about 30-45 minutes and is done with spinal anesthesia. After a few hours, the patient is awake, mobile and can go home the same day or the next morning. “I had patients in amazement that they left home the next day without pain. Just a slight discomfort, which passed in about two days. Not to the pain they came to mind with the stories of others,” adds Dr. Alkadour.
Concrete cases: no pain, no complications
At MedLife, Dr. Alkadour performed the first Hal-Rarar interventions in May 2025, on a batch of three carefully selected patients. Among them, a 69 -year -old patient with III to IV hemorrhoids, who had previously had elastic bands. Although at the limit of the classic surgical indication, the doctor chose Hal-Rara to give you a gentle recovery.
“We did the lifting twice on the same package, because it was a more advanced prolapse. The patient was satisfied, painless, quickly discharged. That means modern medicine: we can adapt to the patient,” he says.
Postoperative feedback was excellent. None of the patients had significant pain, no complications such as bleeding or infection occurred, and social reintegration was rapid. “All the patients called me after two or three days: I have no pain, I'm fine, thank you. Some had the same day with the operation, without problems. For me, the difference from what I was doing before-electrosurgery or laser-it is clear,” says the doctor.
“An intermediate step between classical and robotic surgery in proctology”
Hal-rar technology was developed in Austria and perfected in training centers in Geneva and Athens, where Dr. Alkadour has obtained Hands-on certifications. “The device is designed to be integrated, wireless, to allow a precise and complete maneuver. It is a technique assisted by advanced guidance technology, which can be considered an intermediate step between classical and robotic surgery, without unnecessary aggression. We do not affect the sphincter, we do not do incisions and do not leave, what generates,” he explains.
Compared to traditional treatments, the advantages are clear: without incisions, so without risk of infection or bleeding, without impairment of the anal sphincter, so without risk of incontinence, speedy recovery, minimal pain, easily controllable with ordinary analgesics, low relapse rate.
“Even if the laser has been considered a step forward to the scalpel, and he has his limitations. You do not always know where energy goes. In the Hal-Rar case, the procedure is controlled, selective,” says Dr. Alkadour.
What patients can benefit from hal-rar
Not all patients with hemorrhoids have a direct indication for Hal-rar, but many of those who come to the proctologist are eligible. The intervention is especially recommended for moderate and advanced forms (grades III and IV incipient), with partial or total prolapse.
“After the proctological consultation and evaluation of the degree of impairment, we can decide whether the patient suits Hal-rar. It is important to understand that not all options means suffering or long recovery. Surgery has evolved, and patients deserve to benefit from these minimally invasive techniques,” concludes the proctologist.
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