David E. Bitar, MD, Chief of SurgeryAlta Bates/Summit Medical Center, Berkeley, CA

I have been performing HAL with mucopexies for over 5 years, beginning in April 2010. I have performed around 50 cases.
I am very selective in choosing which hemorrhoidal procedure to perform because of the many options in one's armamentarium these days. I have been very pleased with my results. And so have the patients.
With the newer hand-piece the lighting is greatly improved, which I believe decreases OR time.
I believe the recovery post-surgery is comparable to other procedures, but much less painful than excisional extensive hemorrhoidectomy, and somewhat less painful than a stapled hemorrhoidopexy.
Rectal pressure is the main post operative sensation. Most patients are pain free for 72 hours, with the newer long-acting local anesthetic.
Generally the recovery is quick, and most patients are quickly back working even by the end of the week.
I have had no recurrences, or ongoing problems requiring a further procedure.**