Laser Procedure as a Minimally Invasive Treatment Option in Treatment of Hemorrhoid Disease: Our First Experiences

Abstract

Aim: The treatment of hemorrhoidal disease (HD) is still controversial. After surgery, pain and other uncomfortable complications still pose a significant problem. Therefore, the search for painless treatment in recent years has led to the emergence and popularization of various less invasive techniques. The hemorrhoid laser procedure (HeLP) is a minimally invasive procedure used in the treatment of HH by allowing hemorrhoid packets to shrink with a diode laser. The aim of this study was to analyze the effectiveness of help on postoperative pain, discomfort and other complications in patients with grade II-III hemorrhoids.Materials and Methods: 17 patients were included in the study. The procedure was performed under spinal anesthesia. Patients with grade II-III hemorrhoids were treated with a 1470 nm diode laser. The duration of surgery, post-operative pain and complications, recovery of symptoms and return to daily activity were evaluated retrospectively. Postoperative pain, discomfort, bleeding, complications and recurrence were evaluated at an average follow-up of 18.5±9 months after surgery.Results: The average operating time was 22,9±5 (13-32) minutes. Patients did not develop any intraoperative complications. The postoperative pain score, which was evaluated with visual analog scale, was found to be extremely low. The mean VAS Score (0-10) was 1.058 at 6 hours after the operation, 0.588 after 1 day and 0.176 after 3 days. On 7, 14, 21, 30 days, there was no pain. Therefore, analgesic drugs were administered only if necessary. Postoperative spontaneous hemorrhage and edema occurred in one patient on the first day. The average length of hospitalization of patients after the operation was 19.47±1 (17-23) hours. All patients returned to their daily activities 2 days after surgery. In an average follow-up period of 18,5±9.4(5-36) months, 2 patients (11,764%) had relapses. The Likert-type satisfaction survey conducted on the patients showed that they were all satisfied with the HeLP procedure.Conclusion: Due to very low postoperative pain, discomfort rates and short hospital stay, HeLP can be considered as a painless and minimally invasive technique in the treatment of HH.

Keywords

• hemorrhoid disease
• postoperative pain
• laser
• postoperative bleeding