Revista de enfermedades y trastornos inflamatorios del intestino

Hemorrhoidal Laser Procedure (HeLP): A Painless Treatment for Hemorrhoids

Abstract

Paulo Boarini, Lucas Rodrigues Boarini, Marcelo Rodrigues Boarini, Edgard Mesquita de Lima and Paulo Azeredo Candelaria

Introduction: Hemorrhoidal disease is associated with the theory of arterial blood hyperflow causing swellings in hemorrhoids and, consequently, hyperplasia and venous congestion. The technique helps to promote the obliteration of the terminals of the superior rectal artery branches without the need for anesthesia by electrofulguration with diode fiber LASER. The objective of this study is to describe the results of 55 patients with hemorrhoidal disease treated by the Hemorrhoidal LASER Procedure technique.

Method: Without the need of anesthesia, terminal arterioles of the upper rectal artery are identified by a Doppler transducer (20 MHz probe 3 mm) placed on a specially designed proctoscope. After identification, it promotes arteriolar electrofulguration at 980 nm fiber laser diode, causing interruption of hemorrhoidal flow. This procedure is repeated circumferentially, following the clockwise positions.

Results: Between 2011 and 2014, 55 patients underwent the Hemorrhoidal LASER Procedure technique for hemorrhoidal disease grades I, II and III. There was no need for anesthesia and only two patients required sedation for the procedure. The overall satisfaction rate was 89%, with symptom resolution in 84% and a decrease of at least one grade in hemorrhoidal disease in 80% of cases.

Conclusion: Hemorrhoidal LASER Procedure is a painless outpatient technique that does not require anesthesia, in addition to being safe and easy to perform. It is effective in reducing symptoms and complications of the hemorrhoidal disease grades I and II, with high satisfaction rates.