General Surgery | Posted on 05/12/2020 by
Piles, also known as haemorrhoids are a compilation of inflamed and swollen tissues and veins in the anal canal that have blood vessels, support tissue, muscle, as well as elastic fibres. Piles are caused due to extreme constipation, excessive diarrhoea, and straining while passing stool or lifting heavy items. It can also be caused due to pregnancy or in people who are obese. Moreover, piles can also occur due to family history or genes. Piles can vary in size and could be located inside or outside the anal canal. In most cases, piles do not cause any symptoms and resolve on their own, whereas there can be cases where piles cause extreme discomfort and pain, which might require medical intervention either in the form of medicines or surgery.
Some common symptoms of piles are:
Conditions, where piles reach an intense level, will show symptoms such as:
Piles can be classified into four categories depending on the severity, namely:
That said, there are multiple treatment options to cure the problem of piles depending on the grade of the problem and resultant symptoms. The most definitive form of treatment that has been used over the years is surgery which involves removing the affected areas by cutting them. This is a painful, long and often time risky procedure that will also need you to get multiple dressings and revisit the doctor time and again. Moreover, despite the surgery, the chances of the recurrence of piles still remain. However, with new advancements in medical technology, the problem of piles can be treated by laser surgery which is less invasive, has a shorter recovery time, has low chances of complications or infections, and is significantly less painful. Laser surgery treatment uses high-energy light to safely cut, shrink or burn the piles. Some of the most effective laser treatments applied today by doctors include:
Haemorrhoidal LASER Procedure (HeLP): Haemorrhoidal LASER procedure is a pain-free outpatient form of treatment that is performed without anaesthesia to effectively cure piles of grade 1, 2 and 3. The technique involves identifying terminal branches of the upper rectal artery by using a Doppler transducer, which is placed on a proctoscope. Post identification of the terminal branches, heat from electric current is directed by diode fibre LASER – to destroy the abnormal tissue and cause interruption of blood flow to the haemorrhoidal. The technique is repeated circumferentially per clockwise positions. This technique is simple, less time-consuming, safe and easy to perform. It has been very effective in minimising complications and symptoms for people suffering from piles up to grade 3.
Laser Haemorrhoidoplasty (LHP): Laser Haemorrhoidplasty is used to treat advanced piles by placing patients under anaesthesia and then using the laser energy centrally in the haemorrhoidal node to shrink the piles. This technique uses controlled laser energy that obliterates the nodes internally while safeguarding the mucosa and sphincter structure. The procedure closes the arteries evading the haemorrhoidal cushion, reduces the tissues in the haemorrhoidal node, ensures maximum preservation of the muscle, anal lining, and mucosa, as well as restores the natural anatomical structure. Additionally, fibrotic reconstruction helps in the generation of new tissue to keep the mucosa in the underlying tissue, preventing relapse or recurrence of piles. The procedure involves no use of foreign materials such as clamps and does not cause any wounds in the area. The healing process is fast since there are no incisions, stitches or wounds. Moreover, the pain post-treatment is bearable and the recovery time is fast; most patients resume normal activities within a few days.
Laser Hemorrhoidectomy: In this technique, the doctor passes a laser fibre through the opening in the anal and then directs controlled laser energy to the haemorrhoidal mass. The laser energy reaches the submucosa area, causing shrinkage of the haemorrhoidal mass. The controlled use of laser energy protects the surrounding tissues and ensures minimal bleeding along with quick recovery time. The procedure is followed by a fibrosis reconstruction that 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.