Clinical Application:
Laser Hemorrhoid surgery
Related Keywords:
Hemorrhoidal laser procedure (HeLP),
Doppler‐guided hemorrhoidal artery ligation (HAL),
Transanal hemorrhoidal dearterialization (THD)
Medical device:
VELAS 30Watt 980nm
Accessories:
600um bare fiber
Operation Procedure:
1 Laser settings:
13W Ton 1.2s Toff 0.6s
2 Clinic Science:
Although the real pathophysiology of hemorrhoidal disease remains controversial, the‘‘vascular’’ theory has recently been considered a very likely potential cause of hemorrhoids.
According to this theory, arterial overflow in the superior hemorrhoidal arteries would lead todilatation of the hemorrhoidal venous plexus based on the anatomical findings of arteriovenoushemorrhoidal shunting system without capillary interposition.
Due to preferential thermal coagulating effect on blood of 980nm wavelength, the shrinkageeffect of the laser on submucosal arteries is more selective and periarterial damage of themucosa is extremely reduced.
3 Clinic Procedure:
1) No anesthesia.
2) A specially designed disposable proctoscope is inserted into the rectum3) At the distal end of the proctoscope, there is a small window that holds a Doppler transducer.
3) The Doppler probe identify the terminal branches of the superior hemorrhoidal arteries approximately 3 cm proximal to the dentate line.
4) Once the arterial flow is located, remove the Doppler probe and replace the 600um fiber.
5) Release the laser and reintroduce the Doppler probe to check the closure of the artery.
Advantage:
No anesthesia
Reduced risk of complications
Quick recovery for laser treatmentUsually provide immediate relief of symptoms
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