Barcelona. During recent times Dr. Wafik Al- Wattar , urologist and board-certified in proctology , is seeing how many patients who were suffering from haemorrhoid's leave his clinics happily and with a smile on their faces. This is right: they go out walking after the treatment of previously painful haemorrhoids throughout the technique “Doppler Guided Haemorrhoid Artery Ligation, DGHAL ”.

DGHAL is the new millennium treatment for a problem which has been existing for centuries. It allows a patient that otherwise would undergo an extremely painful surgical operation (a haemorrhoidectomy ) to be treated in approx. 20 minutes, without general anaesthesia or the need to spend a night in hospital (in fact, the treatment can be performed in the doctor's clinics).

“We use a special device (KM-25, a modified proctoscope ), which includes a Doppler transducer and a working window, allowing the surgeon to identify and ligate the haemorrhoidal arteries”, explains Dr. Al- Wattar . This simple manoeuvre ligates and obstructs the terminal portion of the superior rectal arteries which supply blood to the haemorrhoidal tissue. In most cases, through this procedure, we observe that the haemorrhoids start to shrink immediately.

It is interesting to note that, traditionally, it was thought that there were three haemorrhoidal arteries. By means of this technique, however, it has been discovered that there are up to six of such vessels. Thanks to such procedure, the six arteries are ligated.

Furthermore, the DGHAL procedure causes less pain than a normal haemorrhoidectomy . “Through this procedure, pain is considerably reduced, and it is much easier to handle. In consequence, it is possible to be back sooner to every-day activities.” Dr. Al- Wattar notes that more than 90% of his patients return to work within 48 hours and some are back at work on the next day. Given this option, it is not surprising that many patients, not willing to undergo a traditional and painful haemorrhoidectomy , accept this simpler alternative.

This DGHAL method is becoming the standard treatment for haemorrhoids all around the world. More than 10,000 patients have been treated with DGHAL (especially in Japan, Australia, and South-eastern Asia), with an average 95% success. At this moment, surgeons all around Europe are starting to implement DGHAL as a first option treatment. Especially, in Austria, Germany, Italy and England, where many of such surgical interventions are being made on a daily basis with excellent results.

Dr. K. Morinaga , inventor of KM25, Dr. Dennis Meintjes , and Dr. Gorge Karam , world experts in DGHAL , have completed their research with interesting results. This research has encouraged Dr. Al- Wattar to take this treatment into account. “In a study made on 1,415 patients, the treatment was successful for 93.2% of them, and had no success for 6.8% of the patients in a follow-up of 5-24 months. This is really amazing.”

The results of Dr. Wafik Al-Wattar in Catalonia are also impresionants. Until now (2013), approximately 800 were treated in Spain by Dr. Wafik Al-Wattar.

The best candidates are patients with external or internal haemorrhoids as well as those requiring many elastic bands. Additionally, DGHAL is employed to treat haemorrhagic haemorrhoids (internal big haemorrhoids ), which were normally treated by means of elastic bands, and it is also suitable to treat big internal haemorrhoids and big external haemorrhoids .

As a result of the experience acquired in practising this therapy with so many patients, additional advantages have been found:


THERE IS NO NECROSIS (death of tissue because of lack of irrigation)

THERE IS NO SLOUGHING (tissue detachment)

THERE IS NO ISCHEMIA (temporary lack of irrigation)

THERE ARE NO PROBLEMS FOR BOWEL EVACUATION AFTER THE PROCEDURE(contrary to traditional haemorrhoidectomy )


After knowing the DGHAL method, Dr. Al- Wattar has set a general rule for his clinics: when a patient needs a haemorrhoidectomy , he performs a DGHAL procedure instead. “This procedure has proved to be a safe and efficient alternative to haemorrhoidectomy . I would say that our results are as spectacular as those reflected in studies made all over the world...”

Provided that he counts with almost 24 years of professional experience as a doctor, studying all existing methods, from cryo to laser, for the treatment of haemorrhoids , he has accountable enough to claim that the introduction of this procedure is for him “the best option for treating haemorrhoids ”. Dr. Al- Wattar believes that it is just a matter of time for DGHAL to become the standard treatment for haemorrhoids in the whole global medical community.

Finally, the most ancient problem of mankind has a low-cost, easy, safe and simple solution, without general anaesthesia.



What are haemorrhoids and what causes their appearance?
Although the majority of us knows somebody suffering from haemorrhoids , we do not exactly know what they are. Haemorrhoids are swellings of the veins in the upper part of the anal canal as a result of blood congestion in those veins.

One of the confusions in this field is that this condition is only found in elder people. The truth is that haemorrhoids can appear at any age, affecting men in a double proportion as compared with women.

A wide range of factors contributes to this disorder: heredity, climate, age, sex, pregnancy, obesity, and chronically use of suppositories.

Apparently, nutrition also plays an important role: it is known that a fibber-rich diet stimulates the pendulum movement of the intestine and reduces the risk of suffering haemorrhoids . On the other hand, it is generally considered that a low- fiber diet with a high content of carbohydrates can give rise to small and hard excrement's, which are the main cause of colonic constipation and can lead to the appearance of haemorrhoids .

How do I know that I have haemorrhoids ?
This is probably the most usual question posed in family doctor's clinics. The simpler answer is that the majority of symptoms are usually found in patients, haemorrhage being the most common sign indicating that the person is suffering from haemorrhoids .

If you find blood in excrement's, you need to be immediately examined, as this normally means that you have haemorrhoids . Any other cause for the loss of blood must be excluded. Pain is a regular symptom of this pathology when suffering from thrombosis or when a prolapse has incarcerated.

All this may sound alarming, but it is not!

The good news is that there are treatments for haemorrhoids and that not all the episodes of haemorrhoids need an active treatment; there are many cases in which other operations are possible.

Non-surgical treatment

Colonic constipation. The regular intestinal movement is vital: diarrhoea and colonic constipation must be avoided by people suffering from haemorrhoids . Diarrhoea can cause haemorrhoidal congestion and it is essential, during this process, to elevate our level of fibbers and to keep a high level of fluids.

Topical treatment. It refers basically to anti-inflammatory creams, which are very useful in the acute stage of haemorrhoids in any state, but they do not help to reduce a prolapse or to change the state of a lesion.

Non-surgical treatments. Include injection sclerosis, infrared coagulation, elastic band ligature, manual dilatation of the anus and steroids.

Surgical treatment

Until recently, when the patient had tried alternative treatments for his or her haemorrhoids and they failed, the only alternative was to remain in hospital for a selective surgical intervention. In traditional surgical interventions the treatment should necessarily be applied on the haemorrhoidal tissue itself. Frequently, these interventions were incomplete or required a long period of healing, and resulted in anal steno sis, urinary retention and, eventually, severe incontinence.

Our solution to your problems in 15 minutes

An interesting new treatment is possible thanks to a new technique known as “ Transproctoscopic Doppler Ultrasound Haemorrhoidal Artery Ligation” ( TDUHAL ). The treatment can be applied in only 15 minutes, and it does not require any special preparation, not even internment. Instead, it provides immediate alleviation, no pain, no bleeding and any itching or swelling.

Dr. Al- Wattar is in permanent contact with Dr. Kasumasa Morinaga , inventor of KM 25, in Tokio – Japan, as well as with Dr. Dennis Meintjos (Australia), Dr. Norman Sohn (USA), Dr. Jorge Karam (Middle East), Dr. Matthias Scheyer (Austria), Dr. Aguilella (clinic hospital in Zaragoza – Spain), Dr. Mariano Martínez and Dr. José Martínez Ramírez .

Technique approved by American FDA in 1996.

Research carried out by Dr. Norman Sohn on this technique has been admitted by the prestigious magazine American Journal of Surgery and are going to be published soon.

More than 10,000 treatments performed all over the world successfully.

How does it work?

This is the treatment of the new millennium.

It will change for good the way of treating one of the most ancient pains of mankind! The treatment provides immediate and permanent solutions to what used to be a procedure of reasonable high-risk. Once you arrive to one of our clinics, a team of surgeons and nurses will work together so that you receive all the necessary care permanently and in order to answer any doubt arising before and after the therapy.