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Haemorrhoid Surgery / Laser Haemorrhoidoplasty (LHP)

Penang Adventist Hospital  >  Services   >  General Surgery  >  Haemorrhoid Surgery / Laser Haemorrhoidoplasty (LHP)

What Are Haemorrhoids?

The term “haemorrhoids” refers to a condition in which the veins around the anus or lower rectum are swollen and inflamed. Haemorrhoids (piles) arise from congestion of internal or external venous plexuses around the anal canal. Haemorrhoids may result from straining to move stool. Other contributing factors include pregnancy, aging, chronic constipation or diarrhea and anal intercourse. Haemorrhoids are both inside and above the anus (internal) or under the skin around the anus (external).

Internal Haemorrhoids

This form of hemorrhoid is inside the rectum. Internal haemorrhoids usually don’t cause pain or protrude from the anus during bowel movements, but they may bleed. An internal hemorrhoid that prolapses, or extends outside the anus can be quite painful.

External Haemorrhoids

This form of hemorrhoid is located around the anus and when inflamed feels like a hard lump. They are covered by skin, are very sensitive to touch and can bleed, especially while straining during a hard bowel movement.

SYMPTOMS OF HAEMORRHOIDS:

  • The most common symptom of internal haemorrhoids is bright red blood covering the stool on toilet paper or in the toilet bowl.
  • An internal hemorrhoid may protrude through the anus outside the body, becoming irritated and painful.
  • There is painful swelling or hard lump around the anus when a blood clot forms.

The Conditions Tends To Be More Prevalent In:

  • Obese people
  • People who work at a job that requires heavy lifting
  • Pregnant women
  • Those with family history of haemorrhoids
  • People who sit on the toilet too long
WHAT IS LASER SOLUTIONS IN COLOPROCTOLOGY?

Laser Hemorrhoidoplasty (LHP) is an approach used for treatment of advanced haemorrhoids under local, general or spinal anesthesia. The energy of the laser is inserted centrally into the hemorrhoidal node.

There is a direct (30%) and successive shrinkage of the piles (6 weeks to final result).

The controlled laser energy deposition obliterates the nodes from the inside and preserves the mucosa and sphincter structure. The homogenous laser emission from the LHP fiber results in:

  • Closure of the arteries entering the haemorrhoidal cushion
  • Tissue reduction in the haemorrhoidal node
  • Maximum preservation of muscle, anal lining and mucosa
  • Restoration of the natural anatomical structure

The controlled emission of laser energy which applied submucosally, causes the hemorrhoidal mass to shrink. In addition fibrotic reconstruction generates new connective tissue, which ensures that the mucosa adheres to the underlying tissue. This prevents occurrence or reoccurrence of a prolapsed. No foreign materials (clamps) need to be inserted and unlike other procedures, LHP is not associated with any risk of stenosis.

Healing is excellent because, unlike conventional surgeries there are no incisions on stitches.

Access into the hemorrhoid is achieved by entering through a small perianal port. By this approach no wounds are generated in the area of the anoderm or mucosa. As a result the patient experience less post-operative pain and can return to normal activities within a short space of time.

WHAT IS FISTULA-TRACT LASER CLOSURE?

Perianal fistulas result from previous abscess of infections in the perianal area, Primary or recurrent. If treated by laser radiation the granulation / epithelium will be destroyed in a controlled manner by additional shrinking of the superficial muscle layers for oblituation of the tract.

Goals

  • Minimal invasive anal fistula surgery with high preservation of continence (control over fecal discharge).
  • Reduction of pre-operative pain with smaller wounds
  • No excision of fistula tracts therefore saving operating time
  • Fast recovery
  • Reduction of Recurrence

Indications

  • Low fistula
  • High fistula
  • Care of multiple recurrence (Crohn’s Disease)

Contraindication

  • Rectovaginal Fistula
  • Superficial Fistula
  • Fistula with several traits which cannot be added individually

In summary, anal fistula repair using a newly designed radial emitting laser probe in addition to conventional surgery is a useful tool for sphincter preserving and fistula repair thus preserving anal continence.

After therapy of the abscess and Seton drainage the fistula has epithelised.

After conventional closure of the internal fistula opening the probe is inserted into the fistula tract.

Homogeneous application of laser energy radially into the lumen of the fistula. The epithelised tract is destroyed and collapses rear the probe head.