Hemorrhoids Treatment with Laser
New painless laser method for superior functional and cosmetic results
The new generation of flexible lasers using an optical fiber allows the application of minimally invasive techniques for diseases of the anus, such as hemorrhoids, fistulas, abscesses, stretch marks, warts and coccyx cyst. These techniques are applied endoscopically or intraluminally, offering:
- High clinical success rates (>95%)
- Minimal postoperative pain and discomfort
- Excellent aesthetic and anatomical restoration
- Minimal risk of recurrence
Stages – Grades – Hemorrhoid Management
- Grade 1: Hemorrhoids that bleed but have no prolapse
- Grade 2: Hemorrhoids with moderate enlargement and slight prolapse that reduces spontaneously
- Grade 3: Hemorrhoids with significant prolapse that does not reduce spontaneously and requires manual repositioning
- Grade 4: Permanently prolapsed, irreducible hemorrhoids that remain external and cannot be manually reduced.
Laser treatment of 1st And 2nd Degree hemorrhoids – LHP® method (simple Laser Hemorrhoidoplasty (LHP®))
The simple Laser Hemorrhoidoplasty (LHP®) with LHP® laser is the most modern treatment for 1st and 2nd degree hemorrhoids without significant prolapse.
The procedure is performed through a tiny 1-2mm perianal micro-puncture through which a flexible optical laser fiber is directed submucosally into the hemorrhoidal plexus. The method delivers conical 360° laser energy to selectively coagulate the hemorrhoidal tissue from within.
It is completely safe for the rectal wall and sphincter muscles when performed by an experienced specialist colorectal surgeon, unlike obsolete surface-contact lasers.
The laser achieves:
A) Selective coagulation of hemorrhoidal feeding arteries (stopping bleeding immediately), and
B) Progressive shrinkage, volume reduction, and stable fibrosis of the hemorrhoidal node.
The procedure is virtually painless because energy is applied in the submucosal space above the dentate line where sensory pain fibers are absent.
Treatment of 3rd And 4th Grade hemorrhoids – LHP®-RAR method (Laser Hemorrhoidoplasty (LHP®) combined with prolapse plastic)
When prolapsed hemorrhoids coexist, the problem is not only found in bleeding (which can be rare) but also aesthetic and practical (pain, secretions, itching). And when the prolapse is large, as in the 3rd And 4th Degree, simple laser Laser Hemorrhoidoplasty (LHP®) does not have satisfactory results.
In these challenging cases, we combine internal laser coagulation with anatomical mucosal lifting (Recto-Anal Repair - RAR) using fine absorbable sutures that dissolve naturally within 30 days. This combined LHP®-RAR technique, perfected in our surgical department, restores normal anatomy without surgical tissue excision.
The combined LHP®-RAR method comprises:
- Laser Hemorrhoidoplasty (LHP®) internal tissue ablation
- Mucosal lifting and fixation (RAR) with fine absorbable sutures
Relief from hemorrhoidal symptoms and anatomical reduction of prolapse are immediate. The final cosmetic and functional result becomes fully established over 30 days as natural tissue remodeling completes.
Experience shows that it has the best results of all other methods in advanced cases by combining the minimally invasive techniques of laser and endoscopic plastic surgery inside the intestine.
The combination Laser Hemorrhoidoplasty (LHP®) with LHP® laser + ligation of hemorrhoidal arteries + plasty of RAR prolapse combines the advantages of two methods, thus correcting even the most complex cases of hemorrhoids.
We have developed the method after years of experience in hemorrhoids and bowel surgery and we believe it offers the best results of all techniques. The operation lasts about 30-45' and can be done with local anesthesia. The hospitalization lasts a few hours and the postoperative recovery is very short.
You can watch video and Photographs in the incidents section. For more information about the condition of hemorrhoids, symptoms and other treatments you can read here.
Laser Hemorrhoidoplasty (LHP®) (LHP®) + Mucopexy-Recto Anal Lifting (MuRAL) for grade 4 hemorrhoids with an increased degree of difficulty
It is a modification of the LHP®-RAR method for cases of hemorrhoids of the 4th Degree with accompanying problems and an increased degree of difficulty, which until now required classic surgical procedures such as resection according to Milligan-Morgan. It is an extremely demanding technique that requires great experience and expertise from the surgeon. But it can provide a solution in cases that until now were treated only with a scalpel, read more in the corresponding section article.
Myths and reality about laser and LHP® Laser Hemorrhoidoplasty (LHP®).
There is a lot of information circulating on the Internet, positive and negative, true or false about laser Laser Hemorrhoidoplasty (LHP®). I will try to clarify and give the true dimension of the method with the following questions and answers.
Is laser the best method to treat hemorrhoids?
In fact, the laser is the best and newest method at the moment for dealing with hemorrhoids. However, it is not capable of curing every case by itself. In advanced cases of grade 3-4 hemorrhoids with significant prolapse, a combination with plastic surgery using absorbable sutures is needed to better correct the prolapse of the hemorrhoids.
Is the laser painless and without complications?
The truth is that it has much less pain and complications than the rest of the techniques. But it is an operation and no surgical procedure is 100% painless or without complications. Post-operative symptoms depend on the size and stage of the hemorrhoids but are generally mild and far different from the pain stories we've heard about the other methods. Complications (bleeding, abscess, fistula, perforation, incontinence, etc.) are rare when the operation is performed by specialized surgeons.
Is the duration of the operation 15 minutes with 100% success?
The operation can last 15 minutes in cases of the 1st-2nd Degree, but in more complex cases with increased bleeding and prolapse it can take up to 45 minutes (since more extensive use of the laser and additional plastic surgery must be done).
The results last for years but we cannot promise that they are permanent and final, nor that they reach 100%. The reason that hemorrhoids may recur is purely anatomical and functional. As a hernia can recur if the patient continues to lift weights. Just as varicose veins (veins) in the lower extremities recur due to heredity and standing, the same can happen with hemorrhoids due to heredity and constipation. But the truth is that, as a rule, relapses are few and mild. And the effectiveness of the method when done correctly reaches the same levels as the classic removal of hemorrhoids (90%), but without the pain and complications of the classic operation. The other advantage of the technique is that it can be repeated in case of relapse very easily and without side effects.
Do you need to stop taking anticoagulants?
Indeed there is no need to stop simple anticoagulants such as salospir or anticoagulant injections. But strong anticoagulant pills should be stopped and replaced with anticoagulant injections (low molecular weight heparin) for about a week before and after surgery. The dose and time of replacement is determined in consultation with the physician who monitors the patient's anticoagulant treatment (eg cardiologist, pathologist, etc.). Anticoagulant pills, in addition to the risk of severe bleeding or hematoma, also reduce the effectiveness of the laser as they help to rechannel the vessels.
Can the operation be done with intoxication and local anesthesia and without an overnight stay in the hospital?
Laser Hemorrhoidoplasty (LHP®) is a minimally invasive technique so it can be done without the need for general anesthesia and an overnight stay in the clinic. However, there is always consultation with the anesthetist because there are cases where general anesthesia is preferred over intoxication and local.
Is Laser Hemorrhoidoplasty (LHP®) bloodless and simple?
No operation in the anus area is bloodless as the vascularity of the area is particularly rich, simply the loss of blood is minimal because it is done through holes of 1-2 millimeters. It can also be simple for a skilled surgeon but clearly more difficult for a non-specialist, which is why some surgeons avoid it as a method. You can tell if the doctor is familiar with the procedure by seeing if he has posted photos and videos of procedures on his page.
Hemorrhoids with laser surgery price?
The price (cost) of fiber optic laser surgery is comparable or even more economical compared to the price of other methods that use technology such as ultrasound (THD, Angiodin, Trilogy), radio waves (Rafaelo), circular anastomosis (Longo), ultrasound scissors (Harmonic), etc. At the same time, it offers excellent results in all cases of hemorrhoids in a minimally invasive way and with a high safety profile.
Questions, comments and myths about hemorrhoids.
How do hemorrhoids go away naturally?
Fortunately, when internal hemorrhoids are created, they can be improved naturally in the initial stages by eating a healthy diet rich in plant fibers and water and taking care of the proper cleanliness of the area.
Essentially what we aim for is to avoid constipation, heavy lifting, long hours of sitting and all these factors that aggravate hemorrhoidal disease. If we now move to the third and fourth degree, unfortunately there is no possibility of significant improvement with all these preventive measures and as a rule we will have to be led to some kind of operation.
Laser Hemorrhoidoplasty (LHP®) is the ideal method for treating all grades of hemorrhoids.
How many days do hemorrhoids last?
The duration of a hemorrhoidal crisis depends on its type and severity. If we are talking about external hemorrhoids and thrombosis, usually the duration until the thrombosis subsides ranges from one to three weeks.
If it is internal hemorrhoids that have experienced an outbreak that means blood during bowel movements, swelling and prolapse, this usually lasts 1-2 weeks, but over time these phenomena worsen and at some point they may become daily and on a permanent basis.
What is the best ointment for hemorrhoids?
There are many ointments and creams for hemorrhoids on the market, some pharmaceutical and others herbal with herbal extracts or other natural ingredients.
In general, herbal ointments can be used for longer periods without fear of adverse effects, while on the contrary, medicinal ointments that usually contain cortisone in combination with a local anesthetic should be used for a period of 10 to 15 days.
The effect of ointments on hemorrhoids is usually anti-inflammatory, anesthetic and reduces irritation. Relief usually occurs within 2-3 days. Ointments are not a definitive treatment of hemorrhoids, they simply provide relief when there is a flare-up.
Hemorrhoids treatment at home, what can I do?
In addition to the preventive measures we mentioned above and the right diet to prevent hemorrhoids, there are also some practical things we can do at home.
Aloe, which has a strong anti-inflammatory effect and relieves irritation, itching and inflammation, has a beneficial effect on irritated hemorrhoids.
Washing the area with warm water as well as baths with special Epsom salts (sitz bath) reduce swelling - swelling of hemorrhoids and relieve pain and irritation.
Do not use toilet paper when possible. Cotton cloths or wet wipes (without alcohol or other chemicals) with aloe or witch hazel are preferred.
Also, the application of an ice pack wrapped in a towel that we apply to the area for 10-15 minutes relieves the swelling and pain of hemorrhoids.
Can hemorrhoids cause cancer?
No, hemorrhoids do not cause cancer, but according to studies, patients with hemorrhoids are more likely to develop colon cancer, as the causes of hemorrhoids, such as constipation, diet low in fiber, lack of exercise, obesity are also causes of colon cancer.
Therefore, hemorrhoids do not cause cancer, but people with hemorrhoids have a slightly increased chance of developing colon cancer (mainly in the sigmoid and rectum).
Is bleeding from hemorrhoids fatal?
Bleeding from hemorrhoids is not fatal and usually stops on its own within a few minutes, but it can recur a few times within a 24-hour period.
If the bleeding is daily and with enough blood it can lead to a drop in hematocrit.
Dangerous bleeding is rarely seen in people taking strong anticoagulants. In this case we must contact a surgeon immediately.
Is exercise bad for hemorrhoids?
Exercise is generally good for hemorrhoids with the exception of exercises that greatly increase intra-abdominal pressure such as heavy lifting. You prefer exercises such as walking, leisurely jogging, yoga, pilates and avoid weights or cycling when it is at its peak.
Hemorrhoids hot or cold water?
A question that often concerns patients with hemorrhoids is whether they should ultimately use hot or cold water – compresses to wash the area.
As a rule, we should use warm (lukewarm) water at a temperature that is pleasant and relieves us.
Cold water – ice can initially provide relief as it numbs the area and reduces bleeding but in the long term it has an aggravating effect as it causes spasm in the muscles of the area and the sphincter resulting in worsening of hemorrhoids thrombosis or anal fissure and increasing pain.
Warm water helps improve circulation to the area and healing as well as loosening the sphincter and reducing pain. Therefore we can use cold water at the beginning of the crisis when there is intense swelling and bleeding but afterwards it is better to use lukewarm water.
Is swimming in the sea or the pool prohibited?
Bathing as well as washing with water is good for the anus area and the diseases of the area. It should be avoided in cases where the water is contaminated.
What else makes hemorrhoids worse?
Excess weight, stress, unhealthy diet, smoking and alcohol are also aggravating factors and affect the appearance or exacerbation of hemorrhoids.
Delaying bowel movements also worsens hemorrhoids. We should ideally have a daily fixed schedule in terms of our bowel function.
Can hemorrhoids get better over time?
In the very early stages if we improve our diet and our habits we can stop the progress of the disease. But as a rule, if hemorrhoids remain untreated, the symptoms worsen and the stage of the disease increases.