TRILOGY – Locate. Ligate. Lift.

For surgeons, TRILOGY gives you the benefit of Doppler-ultrasound technology with no cables attached. Literally, with a Bluetooth connection between the unit and speaker, you can hear the system’s signals for precise, individual detection of hemorrhoidal arteries while enjoying absolute freedom to maneuver the unit and attached probe as required. In addition, the absence of a cable – which acts as an antenna for surrounding electromagnetic radiation – means the equipment is less sensitive to interference and the arteries can be heard more clearly than ever before.

For patients, HAL-RAR offers a safe and gentle alternative to conventional treatment methods that provides effective relief from all the symptoms of hemorrhoids, even in the more advanced stages. Artery ligation and mucopexy of prolapsing mucosa can be carried out in one procedure under local anestethic, depending on the individual patient and the prevailing healthcare system.


  • The Wi-3 HAL-RAR System enables precise detection of vessels (e.g. hemorrhoidal arteries) by means of Doppler ultrasound technology

  • The Wi-3 HAL-RAR System is a wireless system (battery-driven) and has a Bluetooth technology

  • Bright illumination of surgical area of interest inside the probes (due to three white LEDs)

  • The Wi-3 Arm supports ergonomic handling of the Wi-3 HAL-RAR Unit in the rectum

Benefits [1], [2], [3], [4], [5], [6], [7], [8], [9], [10], [11], [12], [13], [14], [15], [16]

  • Improved Quality of Life and patients’ satisfaction

  • Low risk of peri-operative (shortand long-term postoperative) pain

  • Less post-operative pain compared to hemorrhoidectomy

  • Shorter recovery time compared to hemorrhoidectomy

  • A minimally invasive surgery with a low risk of intra-operative complications which is suitable for ambulatory surgery

  • The ligation window in the probe is adequate and enables a proper manual ligation of detected arteries

  • An effective surgical method after failure of previous treatments

TRILOGY Animated Video – treatment of haemorrhoids

TRILOGY live surgery video

Order Code Product Technical Details


C-TRILOGY battery cap-2

Wi-3 HAL-RAR Unit

Unit for performing HAL-RAR procedures with integrated Bluetooth technology.

Consists of:

  • Doppler-ultrasound electronic unit with integrated Bluetooth transmitter
  • Wi-3 Battery Cap
  • Wi-3 Fixation Nut
  • Wi-3 Battery set
  • High-performance LEDs for excellent visibility
  • New Doppler-ultrasound technology for quick, precise artery detection
  • New Bluetooth technology for cable-free surgery

Multi-use (50 applications)
Delivered non-sterile, steam autoclavable
Batteries: 2 units, AA NiMH, 2100 mAh


Speaker of TRILOGY

Bluetooth loudspeaker for optimal acoustic replay of signals from the TRILOGY Unit (TRI2010) during HAL-RAR procedures.

1 speaker with power cable


Adaptor for Speaker

USB adaptor for connecting the speaker.


1 unit



Replaceable connector for connection to Adaptor.

1 unit,
TRI2220 Connector (Europe)


RAR Flexi Probe

Disposable probe and sleeve set for performing HAL and RAR procedures.
Probe with asymmetric design for the gradual release of mucosa.

5 sets / box
Delivered sterile


Wi-3 Arm

Reusable holder to enhance holding position for the assistance during surgery.

1 unit,
Delivered non-sterile, steam autoclavable

AHN 006

A.M.I. HAL Needleholder

Stainless steel needleholder designed specially to fit the ligation groove inside the probes.

1 instrument,
Delivered non-sterile, steam autoclavable

AHK 007

A.M.I. HAL Knotpusher

Stainless steel knotpusher to facilitate knot tying inside the probes.

1 instrument,
Delivered non-sterile, steam autoclavable


Adaptor Ring

Reusable fixation ring to fix the sleeve of the ultrasound probes.

1 unit,

Delivered non-sterile

[1] T. Sherif and A. Amin Sarhan, “Doppler-guided hemorrhoidal artery ligation with recto-anal repair
versus Milligan Morgan hemorrhoidectomy for grade IV hemorrhoids,” Egypt.
J. Surg., vol. 35, no. 3, p. 155, Jul. 2016, doi: 10.4103/1110-1121.189431.

[2] F. C. López et al., “Prospective Randomized Trial Comparing HAL-RAR Versus Excisional
Hemorrhoidectomy: Postoperative Pain, Clinical Outcomes, and Quality of Life,” Surg. Innov., vol. 26,
no. 3, pp. 1–9, 2019, doi: 10.1177/1553350618822644.

[3] M. DeVos et al., “A retrospective, single-centre analysis on Hemorrhoidal Artery Ligation (HAL) and
Recto-Anal Repair (RAR) after ten years,” Ambul. Surg., vol. 25, no. 1, pp. 5–14, 2019.

[4] B. Trilling, A. Mancini, F. Reche, H. Pfl ieger, P. Y. Sage, and J. L. Faucheron, “Assessment of haemorrhoidal
artery network using Doppler-guided hemorrhoidal artery ligation for hemorrhoids and
pathogenesis implications,” ANZ J. Surg., vol. 89, no. 7, pp. E288–E291, 2019, doi: 10.1111/ans.15143.

[5] H.-U. U. Dorn, “Hemorrhoidal artery ligation/Rectoanal Repair,” Coloproctology, vol. 40, no. 3, pp.
195–203, Jun. 2018, doi: 10.1007/s00053-018-0243-y.

[6] S. R. Brown et al., “Hemorrhoidal artery ligation versus rubber band ligation for the management
of symptomatic second-degree and third-degree hemorrhoids (HubBLe): a multicentre, open-label,
randomised controlled trial,” Lancet, vol. 388, no. 10042, pp. 356–364, 2016,
doi: 10.1016/S0140-6736(16)30584-0.

[7] P. Sirivongs and R. Thiengthiantham, “Short- and Long-term 5-year Clinical Outcomes of Dopplerguided
Hemorrhoidal Artery Ligation and Rectoanal Repair,” Vajira Med. J. J. Urban Med., vol. 60,
no. 1, pp. 5–14, 2016.

[8] C. Hoyuela et al., “HAL-RAR (Doppler guided hemorrhoid artery ligation with recto-anal repair)
is a safe and effective procedure for hemorrhoids. Results of a prospective study after two-years
follow-up,” Int. J. Surg., vol. 28, no. February, pp. 39–44, Apr. 2016, doi: 10.1016/j.ijsu.2016.02.030.

[9] R. Yamoul, G. Attolou, N. Njoumi, S. Alkandry, and M. E. H. Tahiri, “The effectiveness of Doppler
controlled hemorrhoidal artery ligation based on preliminaries results,” Pan Afr. Med. J., vol. 15,
pp. 1–8, 2013, doi: 10.11604/pamj.2013.15.159.2190.

[10] E. Al Zagryadskiy and S. I. Gorelov, “Transanal Doppler-guided Hemorrhoidal Artery Ligation
and Recto Anal Repair vs Closed Hemorrhoidectomy for treatment of grade III-IV hemorrhoids.
A randomized trial,” Pelviperineology, vol. 30, no. 4, pp. 107–112, 2011.

[11] N. P. Forrest, J. Mullerat, C. Evans, and S. B. Middleton, “Doppler-guided hemorrhoidal artery
ligation with recto anal repair: a new technique for the treatment of symptomatic hemorrhoids,”
Int. J. Colorectal Dis., vol. 25, no. 10, pp. 1251–1256, Oct. 2010, doi: 10.1007/s00384-010-0951-4.

[12] A. Testa, G. Torino, and A. Gioia, “DG-RAR (Doppler-guided recto-anal repair): a new mini invasive
technique in the treatment of prolapsed hemorrhoids (grade III-IV): preliminary report.,” Int. Surg.,
vol. 95, no. 3, pp. 265–9, 2010, Accessed: Oct. 31, 2019.

[13] G. E. Theodoropoulos et al., “Doppler-guided hemorrhoidal artery ligation, rectoanal repair,
sutured hemorrhoidopexy and minimal mucocutaneous excision for grades III-IV hemorrhoids:
A multicenter prospective study of safety and effi cacy,” Color. Dis., vol. 12, no. 2, pp. 125–134,
Feb. 2010, doi: 10.1111/j.1463-1318.2008.01739.x.

[14] P. M. Wilkerson, M. Strbac, H. Reece-smith, and S. B. Middleton, “Doppler-guided hemorrhoidal artery
ligation: Long-term outcome and patient satisfaction,” Color. Dis., vol. 11, no. 4, pp. 394–400, 2009,
doi: 10.1111/j.1463-1318.2008.01602.x.

[15] U. Satzinger, W. Feil, and K. Glaser, “Recto Anal Repair (RAR): a viable new treatment option for
high-grade hemorrhoids. One year results of a prospective study,” pelviperineology, vol. 28,
pp. 37–42, 2009.

[16] J.-L. Faucheron and Y. Gangner, “Doppler-Guided Hemorrhoidal Artery Ligation for the Treatment
of Symptomatic Hemorrhoids: Early and Three-Year Follow-up Results in 100 Consecutive Patients,”
Dis. Colon Rectum, vol. 51, no. 6, pp. 945–949, Jun. 2008, doi: 10.1007/s10350-008-9201-z.


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