Hemorrhoids are protrusions of varicose veins and connective tissue around the anal canal extending to inside the rectum. Symptoms are itching, pain, bleeding, and swelling. Hemorrhoids can be internal or external, i.e., inside or outside the rectum. See the pictures below:
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Laser: Except for traditional surgery, laser is the only instrument that can be used on both internal and external hemorrhoids. Laser is used to vaporizes and remove anal & rectal tissue with pinpoint accuracy, one cell layer at a time, until the entire hemorrhoid is removed in puffs of carbonized steam. With laser, there is less pain, less bleeding, and a faster recovery.
Infrared Coagulation: A CO2 laser's invisible infrared light can be used to effect heat-driven coagulation to a specific spot on tissue. By spot welding hemorrhoidal tissue into place, Laser welded hyper-attachments can prevent the hemorrhoids from sagging downward and protruding outside the rectum. A specialized low-technology instrument called an infrared coagulator, is also used for this purpose.
Rubber band Ligation: An internal hemorrhoid is pulled into a small one-inch tube. A rubber band is pushed off the top of the tube onto the hemorrhoid, gripping and strangulating the base of the hemorrhoid, choking off its blood supply. As a result, the hemorrhoid shrivels up and dies, and falls off during a normal bowel movement in about ten days.
Henorrhoidolysis: Low voltage negative galvanic current is applied to an internal hemorrhoid pierced by a needle-tipped electrode. A chemical reaction occurs around the electrode, a white foam appears (hydrogen gas) and the wire becomes loose, due to the liquefying action of sodium hydroxide on the protein around the electrode. The partially liquified part of the hemorrhoid is then reabsorbed into the body's lymphactic system.
Sclerotherapy: A sclerosing agent, typically 5% phenol in oil, is injected into an internal hemorrhoid. The substance injected leads to an inflammatory response, the blood flow into the hemorrhoid is partially blocked, secondary fibrosis is facilitated, shrinking and hardening the hemorrhoid.
Hemorrhoidal Arterial Ligation (H.A.L.) is performed using a modified proctoscope in conjunction with a Doppler ultrasound flowmeter for identification of each hemorrhoid's arterial blood supply, which is subsequently ligated. A needle and thread is passed beneath the artery, and a knot is externally tied, to stop the blood flow to the hemorrhoid. Because less tissue is excised, there is less pain experienced than with traditional hemorrhoid surgery.
Mucosal Prolapse Recto Anal Repair (R.A.R. Proctoplasty) is most often associated with the H.A.L. procedure for reducing severe prolapsing hemorrhoids, resulting from mucosal prolapse of the deep rectum. Prolapsed mucosa is gathered up through an obliterative locking-suture technique, creating tissue scars that integrates “seamlessly” back into the anal tissue, which has the effect of lifting up the hemorrhoids and mucosa and putting them back where they belong. Patients report little discomfort or pain associated with this procedures. Anatomy of Prolapse and Hemorrhoids - Video [3:30]
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