Variceal banding is one method of treatment for esophageal varices that are at risk for rupturing. This concept was based on years of experience treating hemorrhoids with rubber band ligation and works in a similar way. Your doctor will use a lighted endoscope and place an elastic band around the bleeding esophageal vein. Banding the vein will cut off blood flow through the vein. The banded tissue develops into a small ulceration that quickly heals after several days or a few weeks. This procedure is safe, it does not damage the esophageal wall, and it does not increase pressure in the portal system. Variceal banding may be difficult to perform if a vein is actively bleeding because the endoscope obscures your doctor’s vision.