Clinical outcomes of arterial detection ligation technique for grade II/III versus grade IV hemorrhoidal disease

Doppler-guided dearterialization with mucopexy is well established for grade II/III hemorrhoidal disease (HD), whereas evidence supporting its use in grade IV disease remains limited. The arterial detection ligation (ADL) system provides deeper Doppler penetration and improved arterial mapping, potentially enhancing outcomes in advanced disease. This study compared clinical outcomes of ADL-mucopexy between patients with grade II/III and grade IV HD. Patients who underwent ADL-mucopexy between Ju