Reusable vs Disposable Hemorrhoid Banding Ligator: Which is Better and Why?
Choosing to perform rubber band ligation is often an easy decision because it is considered safe and effective.
The more difficult choice in the matter is whether to use a reusable hemorrhoid banding ligator or a disposable hemorrhoid banding ligator.
I want to help you make an informed decision about what's best for you and your patients, so I have compiled this guide to the advantages of each ligator style.
Rubber Band Ligation
Whether performed with reusable or disposable instruments, rubber band ligation procedures are generally the same. In this treatment, the doctor draws the hemorrhoidal tissue away from the rectal wall. Then, the doctor slips a rubber band over the tissue.
This band cuts off blood supply to the hemorrhoid, so the tissue shrinks and falls off. To learn more about ligation procedures, watch the video below by Dr. Nagaraj B. Puttaswamy:
The tool used for this procedure is commonly called a rubber band ligator. It is available in both reusable and disposable forms. Medical teams should weigh the pros and cons of each version to determine which is best for them to use. Studies have demonstrated that both types of ligator are equally effective at banding and eliminating hemorrhoids, so the decision should be made based on other advantages of the two styles.
Advantages of Reusable Ligators
A reusable ligator is one that can be used during multiple treatment sessions. Some doctors choose to use reusable instruments because they lower the costs of treatment supplies and create less waste.
Because reusable ligators are constructed of metal, they are typically more expensive than the disposable plastic versions. However, since they can be used repeatedly, the cost-per-treatment may be less than the cost of purchasing a new disposable ligator each time.
In one study, hemorrhoid ligators were used to treat esophageal problems. Researchers evaluated the cost difference between using reusable and disposable ligators for these procedures. They found that the cost ratio for reusable instruments to disposable instruments was 1:2.37.
Therefore, the researchers came to the conclusion that reusable ligators could be particularly beneficial in low-income areas of the world.
Reduced Environmental Impact
One-time use ligators are typically made of plastic, and manufacturing each one requires an investment of water, energy and raw materials. Furthermore, once a disposable ligator has been used up, it is thrown away. Plastic does not readily biodegrade.
Reusable ligators also go through a manufacturing process, but because less must be produced, and they are not thrown away as quickly, their environmental impact is smaller.
Advantages of Disposable Ligators
Although reusable hemorrhoid banding ligators can be cost-effective and have less of an environmental impact, many doctors choose to use disposable tools. That is because a disposable hemorrhoid banding ligator offers multiple advantages over its reusable counterpart. Disposable tools are clean, time-saving and comfortable, and they are sure to be in good shape.
One of the primary reasons to limit ligators to one use only is that disposable instruments reduce the spread of germs. Reusable instruments must be thoroughly cleaned and sterilized between uses. Even with proper disinfection, there is no way to guarantee that every microbe has been destroyed.
One study showed that 86 percent of handles on hospital instruments still bear bacteria after sterilization procedures. Therefore, the most sanitary approach to colorectal procedures is to use a fresh instrument each time. This protects not only patients but also doctors, nurses and other medical staff who could be unnecessarily exposed to microbes residing on reused instruments.
If a doctor does choose to employ a reusable hemorrhoid banding ligator and clean it between procedures, some experts recommend limiting its use to one patient, such as a person who must receive treatment over the course of multiple sessions.
In addition to the fact that cleaning a reusable instrument may not be completely effective, this process also has the disadvantage of requiring time and effort. After using a reusable ligator, medical staff must take the time to clean and sterilize it. This may require a multi-step process of soaking, scrubbing, rinsing, and heating the tool. Some reusable ligators may also need to be reassembled after cleaning.
If any step is not performed thoroughly, an infection may result, so it is vital that the staff not cut corners. However, in a busy medical setting, committing time to this drawn-out process can be a challenge.
Using a disposable hemorrhoid banding ligator eliminates the need for this lengthy process. Instead, staff members can focus their time on other responsibilities. In the busy world of medical care, every minute counts, and cleaning reusable instruments when disposable ones are available is not always the best use of those minutes.
Different rubber band ligators draw the hemorrhoidal tissue away from the rectal wall in various ways. The two primary methods are to grab the tissue with a clip or to apply gentle suction to it. Although both disposable and reusable ligators can use either method, reusable metal ligators are more likely to use metal clips than disposable plastic instruments are.
Grabbing a hemorrhoid with a metal instrument can be uncomfortable for the patient. Metal clips may even have teeth to improve their hold on the tissue. Pulling the hemorrhoidal tissue with suction is a more gentle approach. Therefore, disposable ligators that work with suction are often preferred above reusable tools with metal grips.
Some research has shown that the quality of surgical instruments can degrade over time. For example, in one study of reusable versus disposable forceps used for colorectal procedures, researchers investigated whether both instrument varieties produced tissue samples of similar quality.
The samples were unusable 27.6 percent of the time when taken with reusable instruments. However, when the doctors used disposable forceps, only 2.7 percent of specimens were inadequate. The researchers surmised that the cutting edges of reusable forceps dull with repeated use, which reduces the instruments' effectiveness.
Granted, a rubber band ligator is not the same type of surgical instrument as a pair of forceps. However, this study serves as a worthwhile reminder that even multi-use instruments do not last forever. To ensure optimal quality for every procedure, there is value in starting with a fresh instrument each time.
While both reusable and disposable ligators have advantages, disposable instruments are generally a cleaner, safer and more convenient way to perform hemorrhoid banding. When considering which of the two types of ligators to use, medical teams should consider that:
If you have questions about the differences between reusable and disposable ligators, please leave a comment below.