To the Editor.—In an article in the Archives (112:534-536, 1977) Bartizal and Slosberg stated, "The traditional approach to the patient with symptomatic hemorrhoids has been operative hemorrhoidectomy."1 I question the wisdom of operative intervention on all symptomatic hemorrhoids as suggested.
The authors went on to report that banding techniques could replace the operative hemorrhoidectomy in many instances. In a 12-month period, 3,208 bandings were done in 670 patients at a cost of $25 per ligation. This comes to $80,200 for this office alone. Not included are additional costs for needed proctoscopic examinations and office check-ups.
Fortunately, conservative physicians have observed that the majority of symptomatic hemorrhoids do not require surgery or banding. Proper instructions of care and time will shrink most hemorrhoids and make them asymptomatic. In addition, the cost to the public is less.