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Hemorrhoid Laser Surgery

Mohd Sufyan   by Mohd Sufyan, BSME, MBA    Last updated on February 20, 2020,

“Surgical treatment methods for hemorrhoids are only recommended when you suffer from a severe case of hemorrhoids, such as grade III and grade IV hemorrhoids. Hemorrhoid laser surgery is considered as an advance treatment method for hemorrhoids.”

 

When Do You Need Hemorrhoid Laser Surgery?

Hemorrhoids laser surgery is effective for treating grade I and grade II hemorrhoids and few grade III hemorrhoid patients. Recent studies have demonstrated the success of hemorrhoid laser surgery against large mucosal prolapse in hemorrhoids.

The procedure involves identification of the terminal branches of the rectal artery using a Doppler. Then photocoagulation of these rectal branches is carried with the help of 980nm laser diode fiber. It is a non-invasive technique and does not require any anesthesia.

Hemorrhoid laser operation is signified as hemorrhoidectomy, as it involves removal of the complete hemorrhoidal tissue. It also reduces the chances of hemorrhoid recurrence.

More About: How to get rid of Hemorrhoids?

More About: Hemorrhoid Surgery

Procedure of Hemorrhoid Laser Surgery

It is an outpatient procedure which leads to inhibition of the hemorrhoidal arterial flow by laser coagulation. During the hemorrhoid laser surgery, anesthesia is usually not provided to the patient, unless he/she requires or asks for it.

Patients do not require any bowel preparation before the surgery.

Following are the steps involved in a typical hemorrhoidal laser surgery:

  • The patient is lied down in lithotomy position
  • A specialized type of proctoscope is placed in the patient’s distal rectum. A small Doppler transducer is drawn through the working window of the proctoscope to identify the terminal branches of the superior rectal artery.
  • Once the arterioles are identified through the Doppler, the Doppler is withdrawn and a 980 nm laser optical fiber is inserted through the proctoscope window.
  • The blood flow to the hemorrhoidal artery is inhibited by activating the laser energy in the optical fiber. This involves initiation of two-operated controlled shots at 2 mm above the mucosa layer, which leads to scorching of the mucosa layer.
  • Then, 3 preset shots for arterial obliteration are initiated. Each of these shots is for 1.2 seconds, given at an interval of 0.6 seconds.
  • The shots efficacy is monitored using a Doppler after a few minutes. If the blood flow still persists, then the doctor initiates another shot at the same site. Such persistence of blood flow can be due to presence of large peri-rectal arteries.
  • Rotation of the rectoscope allows identification of all branches of the superior rectal artery. A single hemorrhoidal laser surgery permits treatment of 12 different branches of the rectal artery.

More: Hemorrhoidectomy for Hemorrhoids

Advantages of Hemorrhoid Laser Surgery

As it is an advanced technique, it has various benefits over the conventional surgical methods and in-office treatment methods.

The advantages of hemorrhoid laser surgery are as follows:

  • The process is less painful and swelling and scarring is less as compared to other traditional surgical methods
  • In major cases, patients do not require hospitalization after the surgery; they can go home after 4-12hrs. This also decreases the cost spent for hospital stay by patients
  • The process is quite safe as it does not involve any steam or smoke during the procedure
  • Laser surgery also reduces the chances of bleeding during and after the surgery, as it seals the blood vessels and stops the blood flow
  • No stitches are made to heal the hemorrhoidal tissue
  • Laser surgery does not lead to any damage or death of the surrounding tissue, thereby reducing the risk of complications
  • This therapy has various medical options, such as use of a wider laser beam to kill large swathe of tissue and a narrow laser beam is used for cutting a smaller tissue area
  • It also eases the work of the doctor who performs the surgery
  • Hemorrhoid laser surgery allows faster healing of the wound
  • Doctors prescribe fewer medications after surgery
  • It is a short procedure which takes about 15-20 minutes
  • Anesthesia is not required for the surgery, so it can be carried out multiple times without damaging the anorectal anatomy and physiology
  • It is an accurate method as it heals the target damaged site directly

 

 

Disadvantages of Hemorrhoid Laser Surgery

Advancement brings along with it several unknown disadvantages which can be harmful for the patients.

Following are the disadvantages of hemorrhoid laser surgery:

  • The laser equipment used during the surgery is quite costly, due to which, this treatment method is not available everywhere
  • The team of doctors and nurses during the surgery need to wear goggles for their protection
  • In rare cases, hemorrhoid laser surgery is reported to caught fire
  • If in case, bleeding occurs during surgery, then the ways to prevent such bleeding is quite expensive and tedious

Most patients and doctors do not advise a surgical procedure for treating hemorrhoids. They prefer natural home-based remedies for hemorrhoids or piles or primarily recommend certain in-office procedures for treating hemorrhoids. If none of these procedures prove to be effective, then the doctor performs a surgery. Do Hemorrhoids Go Away on Their Own?

Frequently Asked Questions

Some surgeries for hemorrhoids treatment may cause minor pain. For example, a surgery to treat small hemorrhoids using sclerotherapy may cause minor pain. Hemorrhoidectomy used to remove multiple very large hemorrhoids may result in significant pain in some cases. You can expect pain in the rectal and anal region after the hemorrhoid surgery which will go away after some time. Your doctor can give you pain relief medicines to manage the pain after the surgery.

After the hemorrhoids surgery, the area might be very sensitive around the surgical site. It might have cuts and stitches and may cause pain. It takes some time to heal the wound. Recovery after the hemorrhoid surgery in general takes about 2 weeks. But it can take longer such as 4 to 6 weeks to recover completely so you feel absolutely normal.

For a few days after the surgery, you will need to be careful. Your doctor will ask you to walk soon after the surgery and during the healing period. However, he will ask you to avoid doing certain tasks such as lifting, pulling, and doing strenuous activity or exercise. You should also avoid straining during bowel movements or when passing urine.

In most cases, people do not have their first bowel movements for a few days after hemorrhoid surgery. Constipation can occur and may be a big problem after the procedure. Your doctor will give you stool softeners to help make your bowel movements easy and smooth.

You will experience some pain after the surgery. If your work involves a lot of sitting, the recovery time may get longer. You shouldn’t sit for too long particularly on the toilet and try not to strain when passing stool or when sitting in general.