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General Surgery | by CMRI
Piles or medically called haemorrhoids are a condition where inflamed and swollen tissues and veins gather in the anal canal causing problems. These tissues and veins are supported by blood vessels, muscle and elastic fibre. They are caused due to several factors such as intense constipation, extreme diarrhoea, straining while passing stool and lifting of heavy items. Moreover, piles can also be caused due to pregnancy, overweight or family history and genes. Piles differ in size and can be found either inside or outside the anal canal.
While in many cases, piles do not cause any problems or pain and tend to dissolve on their own; whereas, on the other hand, many people experience extreme discomfort and pain, and would require medical attention – medications or even surgery, in intense cases.
While the main symptom of piles is the intriguing pain and discomfort, some other symptoms that indicate the presence of piles are:
In patients with severe cases of piles, the symptoms intensify to include:
That said, piles can be classified into four grades basis their intensity:
While there are multiple treatment options for piles – depending on the grade of the problem, the condition of the patient and symptoms – surgery remains the primary treatment course for piles that cause pain and need to be pushed back into the anal canal. Surgery has been used to treat intense piles over the years and involves cutting those hanging sore lumps, relieving the patient of the pain and discomfort. Surgery is long, and painful and also involves slow recovery, as well as multiple visits to the doctor. Moreover, even after the surgery, the chance of recurrence of piles remains very high. But with recent advancements in medical technology, piles can now effectively be treated through laser surgery. This form of surgery is non-invasive, less painful and has a faster recovery rate along with low chances of complications and infections. Laser surgery for piles involves using high-energy light to smoothly remove, shrink or burn the hanging sores – piles.
Haemorrhoidal LASER Procedure (HeLP): This is a very pain-free form of treatment which can easily cure piles of grade 1, 2 and 3. This surgery can be performed in an outpatient facility and requires the patient to be under the influence of anaesthesia. This method uses a Doppler transducer, mounted on a proctoscope – to identify terminal branches of the higher rectal artery. Once the terminal branches are identified, controlled heat from the electric current is used to destroy the abnormal tissue and interrupt the blood flow to the haemorrhoidal. This heat used to destroy the tissue is by a diode fibre LASER and is carried on in all directions per clockwise direction. This method of laser surgery is less time-consuming and is also easy to perform.
Laser Haemorrhoidoplasty (LHP): This method of laser treatment is used to cure piles that have advanced to a greater stage such as Grade 3 and Grade 4. In this form, the patient is placed under anaesthesia, and laser energy is directly centrally to shrink the haemorrhoidal nodes. This form of treatment uses controlled energy to shrink the nodes internally without causing any harm to the mucosa and sphincter structure. This form of treatment directly removes the tissues in the haemorrhoidal nodes. It also closes the arteries escaping the haemorrhoidal cushion to protect the surrounding muscles, anal lining, mucosa and the natural anatomical structure.
Moreover, this surgical procedure helps in the generation of new tissue to keep the mucosa in the underlying tissue, preventing relapse or recurrence of piles. This process does not use any clamps and does not cause any wounds in the area. The healing process post the procedure is fast since there are no stitches, incisions or wounds.
Laser Hemorrhoidectomy: In this laser surgery, the doctor passes a laser fibre via the anal opening and then uses controlled laser energy to treat the haemorrhoidal mass. The laser energy is directed at the sub-mucosa area to shrink the haemorrhoidal mass. This method is very safe, and since it uses controlled laser energy, there is no damage to the surrounding tissues, and also there are low chances of any follow-up bleeding post-surgery. Further, this surgery is followed by a fibrosis reconstruction which helps in the generation of new tissues.
FILAC technique: This procedure involves the treatment of advanced piles by placing the patient under anaesthesia and then centrally directing the energy of the laser radially 360° into the haemorrhoidal node; the technique applies laser energy as per the size of the haemorrhoid to avoid damaging the anoderm or mucosa.
Most laser surgeries are minimally-invasive, non-complicated and easy procedures that help cure the problem of piles, while ensuring minimum after-effects, low risk, lesser pain, shorter recovery time and low relapse probability.