Laser hemorrhoidoplasty: A minimally invasive approach for the hemorrhoids

Hemorrhoids are enlarged, bulging veins in and around the anus and the lower rectum. The veins around the anus tend to stretch under an increased pressure. Depending on the locations, hemorrhoids can develop inside the anal canal, known as internal hemorrhoids or at the anal opening, called external hemorrhoids. Contributing factors to the hemorrhoid issues are the excessive straining while having the motions, chronic constipation and sitting in the toilet for a long time period as well as less fiber consumption. Hemorrhoid (internal) issues can be classified according to the severity based on the extent of the prolapse, ranging from grade 1 to 4 meaning that the prolapses may progress and require manual reduction. If these symptoms are left untreated, the prolapse may remain outside of the anus during days and nights. Furthermore, for the external hemorrhoid, the excessive straining may lead to the internal bleeding and become thrombosed (the blot clot has formed in the hemorrhoid). The patient may feel a hard, painful lump outside their anus. If too much pressure builds up in a thrombosed hemorrhoid, it can burst. 

Warning signs and symptoms

• Rectal bleeding (usually painless)
• Palpable hard lump next to the anus (thrombosed external hemorrhoid) that may cause discomfort and pain
• Prolapsed or protruding hemorrhoids 
• Irritation, itchiness or swelling around the anus 

Laser hemorrhoidoplasty

Laser hemorrhoidoplasty is a relatively new procedure for hemorrhoid treatment in which the hemorrhoidal blood flow is coagulated by the laser. Prior to procedure, patients need to be anesthetized by the anesthesiologist. Subsequently, the procedure will be conducted by the coloproctologist / colorectal surgeon, the laser probe will be inserted into the hemorrhoids. Due to an intense amount of heat, the laser beam cauterizes and seals off the blood vessels, therefore the hemorrhoid will simply shrink while reducing the risk of excessive bleeding during and after the procedure. Since laser hemorrhoidoplasty is a precise procedure, it leaves no effect to the surrounding tissues as well as the anal sphincters.

The advantages

• Fewer potential risks and complications
• Less pain
• Rapid recovery and return to the daily routine

Lifestyle modifications to minimize the risk for hemorrhoids

Healthy bowel habits and lifestyle modifications can significantly lower the risk for hemorrhoids. 

• Avoid sitting in the toilet for too long (longer than 5-10 minutes), e.g. reading a book and using mobile phone, as it may increase the pressure on the hemorrhoids.
• Do not hold in stool when the urge comes to hard stool and difficult bowel movements. 
• Avoid excessive straining.
• Taking high-fiber diet e.g. fruits and vegetables.
• Drink plenty of water, at least 6-8 cups per day to help keep stools soft.

Recurrent hemorrhoids are considerably common. However, the severity might be varied. Among the several treatment options, the most appropriate approach for each patient will be discussed in detail with the coloproctologist / colorectal surgeon who will definitely take clinical presentations, disease severity and patient’s overall health conditions and concerns into account.   

Laser hemorrhoidoplasty is considered a minimally invasive procedure for hemorrhoid treatment. The procedure allows the patient to achieve the best possible outcomes with minimal discomfort, rapid recovery. The patient will return to daily routine quicker with a good quality of life.