Treating Hemorrhoids or Piles using the latest laser technology

Gastro Sciences | by Dr. Ajay Mandal | Published on 10/04/2020

Piles or medically called hemorrhoids 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 fiber. They are caused due to several factors such as intense constipation, extreme diarrhea, straining while passing stool, and lifting heavy items. Moreover, piles can also be caused due to pregnancy, being 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 it the intriguing pain and discomfort, some other symptoms that indicate the presence of piles are:

 

•    Formation of hard, painful lumps in or around the anus
•    Feeling unexplainably full even right after passing stool
•    Blood post a bowel movement
•    The red, itchy swollen area around the anus
•    Pain upon the passing of stool

 

In patients with severe cases of piles, the symptoms intensify to include:

 

•    Excessive and out-of-control bleeding from the anal
•    Infection
•    Loss of control of bowel movement
•    Development of a new pathway between the area around the anus and inside the anus
•    Blood clots

 

That said, piles can be classified into four grades basis their intensity:

 

•    Grade 1: In this grade, the patient develops invisible, small inflammations inside the lining of the anus
•    Grade 2: This form of piles is bigger than Grade 1 and is also found inside the anus; however, they can easily pass through stool but also have a chance of recurring.
•    Grade 3: This form of piles is extremely painful and can be seen hanging from outside the anus. These can be reinserted easily.
•    Grade 4: These piles are painful, hang outside the anus as sore lumps, and cannot be pushed back without treatment.

 

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.

 

Some of the major forms of laser surgeries used to treat piles include:

 

Haemorrhoidal LASER Procedure (HeLP): This is a very pain-free form of treatment that can easily cure piles of grades 1, 2, and 3. This surgery can be performed in an outpatient facility and requires the patient to be under the influence of anesthesia. 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 fiber 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 anesthesia, 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-procedure is fast since there are no stitches, incisions, or wounds.

 

Laser Hemorrhoidectomy: In this laser surgery, the doctor passes a laser fiber 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 anesthesia 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 hemorrhoid 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.