Some internal hemorrhoids are removed by tying them off with rubber bands in an outpatient procedure called rubber band ligation. The instrument used (ligator) consists of forceps surrounded by a cylinder with ¼-inch (½-centimeter) rubber bands placed on one end. The ligator is inserted into the anus through an anoscope (a short, rigid viewing tube), and the hemorrhoid is grasped with the forceps. The cylinder is slid upward over the forceps and the hemorrhoid, pushing the rubber bands off the cylinder and around the base of the hemorrhoid. The rubber bands cut off the hemorrhoid's blood supply, causing it to wither and drop off painlessly in a few days. One hemorrhoid is ligated about every 2 weeks. Several treatments may be required. Sometimes, multiple hemorrhoids can be ligated at a single visit.