1. The patient is positioned in Lateral Recumbent or in a Lithotomy Position.
   
   
2. Ultra Sound Gel is put on the A.M.I. HAL-Doppler Proctoscope before it is fully trans-anally inserted and slowly/gently turned until a typical Doppler sound of arterial blood flow can be heard.
   
   
3. The identified arteries are ligated in a distance 3 to 4 cm proximal to the Dentate Line through the ligation window of the A.M.I. HAL-Doppler Proctoscope, thus reducing the blood inflow to the inner hemorrhoidal plexus. 

Good control

• Rapid identification of terminal branches of superior hemorrhoidal artery

• Precise, accurate ligation

• Immediate confirmation

Minimum discomfort

• Minimally invasive surgery

• Ligation sutures are placed 2-3 cm above dentate line

• General or MAC sedation

High success rate

• 90% or greater success rate

• No major complications reported

• Ratio of inflow to outflow drops significantly