Mr Giovanni Tebala, consultant colorectal, upper GI & laparoscopic surgeon, based in Reading, Windsor and Slough, briefly explains why Rafaelo is so efficient and effective for his patients

Rafaelo® Procedure: a fast and effective new treatment of haemorrhoids


Published: 25/10/2019 | Updated: 21/02/2020


Around 50% of adults experience haemorrhoids by the age of 50. Most of the time, they go away on their own, but if your haemorrhoids are persistent or reoccurring, you may want to consider this new treatment available. Mr Giovanni Tebala, a consultant colorectal, upper GI & laparoscopic surgeon based in Reading, Windsor and Slough, offers this treatment and briefly explains why it’s so efficient and effective for his patients.


Image of an operation


What is the Rafaelo® Procedure?

The Rafaelo procedure is a new and effective procedure to treat the so-called haemorrhoidal disease. It’s minimally invasive and aims to shrink the engorged haemorrhoidal cushions with the use of radiofrequency energy.


Who needs the Rafaelo® procedure?

The Rafaelo procedure can be used on any patient with haemorrhoids. The particular nature of the Rafaelo treatment makes it suitable mostly for patients with first or second degreehaemorrhoids (internal haemorrhoids), although good results have been obtained also in some patients with third and fourth degree haemorrhoids.


What does the Rafaelo® procedure involve?

The Rafaelo procedure can be performed under local, regional or general anaesthesia. Clearly, the advantages of mini-invasiveness can be appreciated mostly if the patient is under local anaesthesia, with or without a minimal sedation. In these conditions, the patient should be able to leave the hospital a few minutes after the procedure.


A small proctoscope is inserted into the anus and, once the haemorrhoids to be treated have been identified, a radiofrequency probe is inserted into each cushion and activated for a few seconds. This energy causes shrinkage of the haemorrhoids and produces a minimal amount of scar tissue that fixes the haemorrhoids to the underlying tissues and eventually reduces the prolapse component.


The operation takes less than 20 minutes and can be associated to other procedures such as colonoscopy, Botox injection, manual proctopexy, partial haemorrhoidectomy and excision of skin tags.


Are there any risks of complications with the Rafaelo® procedure?

Each and every surgical procedure has a risk of complications. Untoward side effects and complications can happen also with Rafaelo, but the risk is very low.


Anal discomfort and discharge for few days are common side effects, but usually they don’t interfere with the patient’s everyday activities and can be easily tolerated.


Much more rarely, the patient can develop a perianal infection that may need antibiotics and/or drainage.


Minimal bleeding is possible 5-10 days after the procedure, but usually it is self-resolving and shouldn’t be of much concern.


How long does recovery take?

Immediately after the procedure the patient is able to go to the recovery room, if they had general anaesthesia or sedation. Otherwise, they can go straight to their room.


Post-procedure pain is usually minimal and well tolerated with common non-opioid pain-killers. We always suggest at least 24-48 hours of rest at home before going back to work, but patients should be able to restart their normal activities very soon after the procedure.


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West Hertfordshire NHS Trust offers The Rafaelo Procedure

West Hertfordshire NHS Trust is the latest NHS trust to offer The Rafaelo Procedure. Initially at St Albans City Hospital, Mr Atif Alvi FRCS and his colleagues, including Mr James Arbuckle FRCS, are offering Rafaelo routinely with several lists planned.

Harley Street welcomes the Rafaelo Procedure

Cosmedic Clinics at 41 Harley Street in London has today begun offering The Rafaelo Procedure to its patients. Under the expert hand of Mr Alex Von Roon FRCS, of University College London Hospital, regular Rafaelo lists are planned at the state of the art clinic in central London. To find out more, CLICK HERE


Spire Leicester is the latest Spire hospital to offer The Rafaelo Procedure

Today Mr Mike Norwood FRCS carried out his first Rafaelo treatment on a private patient at Spire Leicester Hospital. More lists are planned.

Another Nuffield Hospital joins the Rafaelo revolution

The Vale Hospital in Glamorgan,  southern Wales, is the latest Nuffield Hospital to add The Rafaelo Procedure to its range of treatments for haemorrhoids. Mr Alan Woodward FRCS has begun offering the treatment to his patients.

Spire Harpenden extends its offering of The Rafaelo Procedure

Spire Harpenden, near St. Albans in Hertfordshire, has been offering The Rafaelo Procedure under Mr Alla Amin FRCS for the past couple of years and he has already topped 100 patients. Today Mr Atif Alvi FRCS, consultant Colorectal Surgeon, carried out his first list there and plans to offer it routinely going forward.

Chelsea & Westminster NHS Trust offer The Rafaelo Procedure

Mr Jason Smith FRCS, colorectal surgeon and clinical lead at Chelsea and Westminster Trust has carried out his first list at West Middlesex Hospital, part of Chelsea and Westminster NHS Trust. Regular Rafaelo lists are now planned and will be offered routinely going forward. The next list is planned for Monday 2nd March.

First list at The Lister

Yesterday we assisted Mr Oliver Warren FRCS with his first Rafaelo list at HCA The Lister hospital in Chelsea. Having invested in The Rafaelo Procedure, The Lister plans to offer this revolutionary treatment routinely moving forward into 2020.

Rafaelo expands into the NHS

Havering and Redbridge NHS Trust have introduced The Rafaelo Procedure at Queens Hospital in Romford. Led by Consultant colorectal surgeon Mr Richard Boulton, Queens are now offering Rafaelo as a routine procedure for local haemorrhoid patients.

The Whiteley Clinic adds Rafaelo to their treatment offering at their Bristol Clinic

Professor Mark Whiteley’s Whiteley Clinics, who currently offer Rafaelo at their London, Birmingham and Guildford Clinics, now offer the procedure from their Bristol clinic. Under the expert hand of Mr Simon Middleton FRCS, colorectal surgeon, Bristol residents and those from surrounding areas are able to benefit from this revolutionary walk-in walk-out procedure.