Laser Treatment in Hemorrhoidal Diseases

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    Surgery means being patient and disciplined while constantly working

    at high performance and never being able to say (it's me). Op.Dr. Hakan Bayri
     

    Laser Treatment in Hemorrhoidal Diseases

    BLOG 02.05.2024

    Laser application in the treatment of hemorrhoidal diseases has its place in today's treatment algorithm as a method that can be used apart from surgical treatment options. Many articles on the subject of ''Laser hemorrhoidoplasty'' can be found in the medical literature. When all this literature information is examined, the common view is that although laser treatment cannot be the sole treatment option for all types of hemorrhoidal disease, it can be used at an acceptable level of success with appropriate patient selection.

    I would like to underline that laser treatment, although used in many areas of medicine, is a method open to abuse as a commercial object. The complaint of pain after surgery such as the anal region is an important problem, and the risk of muscle group damage around the anus after the intervention of the inexperienced physician group in proctological interventions, the risk of incontinence, the problem of stenosis around the anus after the surgical intervention, and without ignoring the problem of laser treatment, with appropriate patient selection, scientific data provide the patient with a chance of success. It is appropriate to share it.

    As in all proctological interventions, it is extremely important for the physician to be familiar with the subject in laser hemorrhoidoplasty. The rate of success will be determined by advancing the laser probe in the avascular plane between the internal muscle groups and the hemorrhoid pavement and then firing it at the appropriate depth. It should be kept in mind that in cases where you do not have mastery of the anatomy and procedure, the laser hemorrhoidoplasty procedure will fail and many undesirable situations may be encountered during the procedure, such as bleeding in the hemorrhoidal package, postoperative pain due to damage to the mucosa lining the inner surface of the hemorrhoidal package, and thermal damage to the internal muscle groups. Although there are many laser devices and probes in the industry, it is important to use devices and high-tech probes suitable for proctology interventions (a device that can pulse at the appropriate wavelength).

    The pulses (at the appropriate wavelength) made by the surgeon with the intervention from the appropriate plan (a 360-degree circular pulse is made from the laser probe) will provide the desired ablation in the hemorrhoid package. In hemorrhoidal packs, ablation with fibrosis (that is, sealing of the hemorrhoid to the inner wall after surgery) is expected 6-8 weeks after the operation. It is extremely important for the physician to inform his patient about this scientific fact before surgery.

    As a result, it should be accepted that laser therapy can be used in the treatment of hemorrhoidal disease in the appropriate patient group with the advancement of technology and the use of reliable devices with appropriate wavelengths in the right hands.