LHP – Laser Hemorrhoidoplasty

The most advanced method of surgical treatment of hemorrhoidal disease; it has been used all around the world, as well as in Polyclinic Lege Artis for the past couple of years with excellent results.

It is very attractive due to minimum invasiveness: postoperative course is almost painless; there are no incisions, no sutures, open wounds and bleeding; no complications that occur with classical techniques. Return to daily activities is possible after a very short time.

It is performed with hemorrhoids of grade II and III that are uncomplicated.

Description of the procedure

LHP is performed using BIOLITEC laser: its fiber optical thread applies radial laser beam to target tissue. The laser beam causes a fibrous reaction in endothelial (inner) cells of hemorrhoidal vessels and in cells of connective tissue. Fibrous reaction leads to narrowing or even closing of the blood vessels that supply hemorrhoidal cushions with blood, which causes their ‘deflation’ and ‘drying’. Likewise, fibrous reaction in perihemorrhoidal connective tissue leads to retraction and fixation in the anal canal, which solves the problem of ‘prolapse’ of hemorrhoids. In short, the same procedure alleviates all symptoms and discomforts caused by hemorrhoids: bleeding, prolapse, pain.

Candidates

Patients with grade II and III of hemorrhoidal disease – characterized by some of the symptoms: perianal eczema, itching, fresh blood in stool or on toilet paper, feeling of fullness in the anus, occasional pain in defecation with intermittent prolapse – prolapse of nodes that can be repositioned. Limitations: patients with grade IV of already advanced and unkempt hemorrhoidal disease with fixed non-reducible hemorrhoids, with irregular defecation or profuse bleeding and frequent inflammations. In such cases, LHP is combined with some of the other surgical techniques – most commonly with classical hemorrhoidectomy, with great results, as well.

Preparation

Act according to the instructions given by the anesthesiologist during the preoperative examination. Day before the procedure, have a light lunch (soup, cooked meat/fish, vegetables or pasta, rice…). About 2 hours after that start the preparation with MoviPrep – follow the instructions. First ‘dose’, i.e. 1l of the preparation dissolved in water – must be drunk right away. Second ‘dose’ should be taken in the evening (perhaps early in the morning is possible, if you are a ‘morning type’, or the procedure is scheduled after 11am). On the day of surgery, in the morning, approx. 2 hours before the procedure, drink 0,5l of Donat Mg. Simultaneously with preparation, i.e. ingestion of MoviPrep, drink enough fluid due to loss of liquid via defecation; the best is water, tea, mild juice. Come for the procedure on an empty stomach.

Course of the procedure

The intervention is done under general intravenous anesthesia; through minimal incisions near the anus (diameter 2-3mm), so there are no incisions and surgical wounds during the procedure.
Reduction of the very hemorrhoidal nodes is done without damage to surrounding tissue. Branches of lower and lateral hemorrhoidal artery are obliterated (closed using laser beam), while preserving the mucosa and anal sphincter. Likewise, desired tissue reaction to the laser beam develops in 6 weeks after the intervention.

Recovery

Due to the aforementioned, postoperative course is very easy and relatively comfortable – it flows practically painlessly. Compared to other surgical procedures, this method is certainly the most popular in patients because of its minimal invasiveness and absence of postoperative pain.
Return to all life and work activities is possible a couple of days after the intervention.

Side effects and complications

As well as with other surgical procedures in this region, bleeding of different volume is possible. But, with correct preparation of the patient and adequately performed technique by an expert surgeon, this complication is negligible.
Possible disadvantage, in today’s situation, the price of this procedure, which is determined by the one-time use fiber optic thread and set, can be a problem. That is why the application of this method in institutional healthcare is very sporadic.

Package includes: preoperative examination by an anesthesiologist, procedure itself, thromboprophylaxis if necessary, analgesics for 1-2 postoperative days and control examinations during the next 6 months.
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