Rafaelo Procedure for Haemorrhoids

Initial consultation

Before having the Rafaelo procedure, you’ll have an initial consultation with a colorectal surgeon. During this appointment, the surgeon will carefully assess your haemorrhoids and discuss the most appropriate treatment options, including whether the Rafaelo procedure is suitable for your case.

This consultation offers you the opportunity to ask questions and raise any concerns, ensuring you are fully informed about the procedure. The surgeon will also explain how to prepare for the treatment and what to expect during and after the procedure, helping you feel confident and comfortable throughout your treatment journey.

Treatment options

There are several treatment options for haemorrhoids, depending on their severity, symptoms, and whether they are internal or external. For mild symptoms, conservative measures such as dietary changes, increased fibre intake, hydration, and topical treatments can help relieve discomfort, including itching and soreness.

For internal haemorrhoids that do not respond to lifestyle measures, minimally invasive procedures may be recommended. These include the Rafaelo procedure, rubber band ligation, and haemorrhoidal artery ligation (performed under general anaesthesia), all of which aim to reduce blood flow to the haemorrhoid and encourage it to shrink.

The Rafaelo procedure is particularly suitable for treating internal haemorrhoids graded 2-3 and offers effective symptom relief with minimal discomfort and rapid recovery. For more advanced haemorrhoids, such as large prolapsing (grade 3-4) haemorrhoids or cases that have not improved with less invasive treatments, surgical haemorrhoidectomy may be recommended.

Your colorectal surgeon will discuss all suitable options with you and help determine the most appropriate treatment based on your symptoms, haemorrhoid grade, and overall health.

Preparing for the procedure

Proper preparation for the Rafaelo procedure involves following your surgeon’s specific instructions. This may include dietary adjustments to increase fibre and fluid intake, which help prevent constipation before and after the treatment.

You may also be advised to stop smoking and avoid certain medications to minimise risks during the procedure. Your surgeon will provide detailed guidance on what to expect during the treatment and recovery, including potential side effects and how to manage them.

You’re encouraged to ask questions and discuss any concerns at any stage to ensure you feel well prepared and supported throughout the process.

On the day of your Rafaelo treatment, you will be welcomed into the procedure room and made comfortable by the clinical team. You will then be asked to lie on your left-hand side with your knees gently drawn up towards your chest, allowing the surgeon safe and effective access to the treatment area.

After administering a local anaesthetic to ensure your comfort, the surgeon will use a special needle probe to deliver controlled radiofrequency energy directly to the haemorrhoidal tissue. This energy reduces the haemorrhoid’s blood supply, causing it to shrink and eventually disappear.

The procedure typically takes between 30 and 45 minutes, during which most patients experience minimal discomfort. It does get hot when the radiofrequency energy is applied and this is a normal part of the procedure. You and the surgeon will work together to moderate the heat energy applied to minimise the risk of excessive heat energy application, which can cause mucosal breakdown – this may lead to increased post-operative pain but this does settle quite quickly.

Recovery from the Rafaelo procedure is generally swift, with most patients able to resume normal activities immediately. Maintaining a high-fibre diet and drinking plenty of water are important for preventing constipation and reducing straining during bowel movements, thereby supporting the healing process.

Mild side effects such as bright red bleeding, discomfort, or anal discharge may occur for a few days after the procedure and are considered normal. A small amount of rectal bleeding or spotting may also occur within the first two weeks. You should seek urgent medical attention if bleeding becomes heavy, persistent, or worsens, particularly if you are soaking through pads, passing large blood clots, or feeling dizzy, faint, or unwell.

Some patients may experience a sensation of urgency to open their bowels for up to two days after the procedure, even if they are unable to pass stool. Most people do not require painkillers after treatment, but it is advisable to have paracetamol and ibuprofen at home for mild pain relief in the first couple of days.

You are generally able to drive and use public transport unaccompanied if the procedure was performed under local anaesthesia. Follow-up appointments will be scheduled, typically around four weeks after treatment, to monitor your progress and ensure you are satisfied with the outcome.

Risks and complications

The Rafaelo procedure is considered safe and effective, but as with any treatment, there are some potential risks. Potential complications can arise within the first two weeks after treatment and may include bleeding, infection, or urinary retention.

Occasionally, complications such as anal fissures or increased urgency may cause discomfort around the anus and back passage. Serious complications are rare, but it is important to be aware of the risks and discuss them with your surgeon beforehand.

Your healthcare provider will give you detailed instructions to minimise risks and manage any side effects, ensuring the best possible recovery and treatment outcome. Attending all follow-up appointments is essential to monitor healing and promptly address any concerns.