The surgeon then ties off each artery (called ligation) by placing a stitch around it and knotting the ends. Because the stitch is placed not in the anus but in the lower rectum, where there are almost no pain nerves, the whole procedure is virtually painless.
With the blood supply to the haemorrhoids being obstructed, the pressure in them is reduced almost immediately and they start to shrink. In just a few weeks, they are no longer noticeable and the symptoms resolve. Where necessary (for example in the case of Grade III or IV haemorrhoids), RAR (Recto Anal Repair) can also be used to reposition the prolapsing haemorrhoids.