Infrared photocoagulation. What is photocoagulation of hemorrhoids and reviews about it. Disadvantages and advantages of infrared photocoagulation

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• The essence of technology
• Carrying out the procedure
• Precautions and Limitations
• Experience in applying the technique

Infrared coagulation of hemorrhoids is one of the options for non-surgical treatment of hemorrhoids. This method turns out to be very effective when used in a timely manner. It should always be remembered that neglected pathology causes serious problems, which are often solved by emergency surgery. Only taking measures at the initial stages makes it possible to completely cure without radical operations, and the technology under consideration allows it to be provided quickly and safely.

The essence of technology

At its core, hemorrhoids are the development of sac-like swellings on the walls of the venous plexus of the rectum in the anal area, which are called hemorrhoids. An exacerbation of the disease occurs when these sacs are filled with a blood mass, which occurs when there are disorders in the venous outflow of blood. These exacerbations cause serious consequences associated with bleeding, inflammation, the risk of infection, prolapse and pinching of the missing nodes.

The cure of the pathology is possible only with the elimination of the formed venous formations, which is provided by various methods. In general, coagulation is a process of influencing the blood, when platelets, which release thromboplastin, are concentrated in the treatment area. It, in turn, combines with prothrombin, vitamin K and calcium, converts fibrinogen to fibrin with the formation of a fibrin network that prevents blood flow and forms a thrombus in the right place.

Infrared coagulation, or rather, photocoagulation of hemorrhoids, is based on the fact that radiation provides a thermal effect at the base (leg) of the node, which creates a coagulation effect in this area, i.e. thrombus at the entrance to the swelling cavity. As a result of blocking blood flow inside the hemorrhoid, it remains without blood supply. The mass already present in the cavity thickens, and the walls of the bag stick together. Gradually, education dies off and dries up.

Coagulation of hemorrhoids is carried out using a focused infrared beam generated by a special source and directed to a given point through a light guide. The apparatus (coagulator) for the procedure includes a power generating unit, a hand-held applicator and a rigid-type quartz light guide with a tip for precise beam direction.

A low-voltage halogen-tungsten lamp is used as a source of infrared radiation. Its reflector has an absolutely even reflective coating, which makes it possible to focus the light flux and direct it into the quartz channel of the fiber. The tip is made of a special material that excludes the dissipation of energy, and therefore putting it in contact with the hemorrhoid allows you to provide the necessary heating. The radiation power and the duration of its exposure can be regulated. The timer is capable of adjusting the time in the range of 0.5-4 s.

Thus, the coagulation of hemorrhoids with the help of an infrared ray penetrates the leg of the node, where, as a result of the necessary heating, the process of hardening of the cavity is generated.

The depth of penetration of radiation into the tissue is regulated to the required level. The considered technique is effective in the following circumstances:

• in the presence of a bleeding or circular combined external node with hemorrhoids of 1-2 degrees;
• It is also recommended for the elimination of small hemorrhoidal defects remaining after treatment with radical methods (hemorrhoidal ectomy or latex alloying).

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Carrying out the procedure

Coagulation is carried out when the patient is placed in a chair with the legs pressed to the abdomen in the knee-elbow position or placed on the side. The procedure is performed using an anoscope 5–10 cm long and a tube diameter of 17–20 mm, which provides illumination and the ability to control the process. The tube of the device is inserted through the anus until it contacts the hemorrhoid. The tip of the coagulator light guide is immersed in the anoscope channel. Smooth movement of the tip provides an impact at 3-5 points of the hemorrhoid stem, located at a distance of 3-5 mm from each other. The duration of irradiation is set taking into account the size of the bulge and is 1–3 s.

In one procedure, 3-4 formations can be processed. The next action can be carried out in 13-15 days.

The total course of treatment can include from 1 to 7 sessions. If a large-sized node is treated, then not only its leg is exposed to coagulation, but also the body itself. Photocoagulation can be performed on bleeding swellings. In this case, first, drying with a tupfer is carried out, and then coagulation is provided for 2.5–3 s, after which the bleeding stops.

After the session, a short-term discomfort is possible for 4–5 hours. Some people experience slight pain when the tip is deepened too much. If the pain syndrome lasts longer than the specified time, then measures are taken to eliminate it. Most often this is due to the cessation of the inflammatory response. Sometimes there is an increase in body temperature at the site of exposure, there is a sensation similar to acupuncture. Such phenomena should disappear within 1-2 hours after the procedure.

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Precautions and Limitations

• anal fissures;
• developed cryptitis;
• rectal fistulas;
• the presence of proctitis and other inflammatory pathologies.

After coagulation, the diet should be supplemented with foods high in fiber; in addition, it is necessary to increase the drinking regime. You will have to give up poorly processed food, alcohol and significant physical exertion within 30-40 days. During the procedure, there is a risk of thrombosis of healthy tissues, which can cause bleeding. With this in mind, it is not recommended to take aspirin for 14-16 days, as well as other drugs that can thin the blood.

In general, infrared coagulation refers to a safe method of treating hemorrhoids, but this condition is guaranteed only by performing procedures in specialized clinics with experienced specialists. The price of a course of treatment depends on the complexity of the impact, but on average ranges from 2,000 to 6,500 rubles.

Recently, specialists are increasingly resorting to the treatment of hemorrhoids with minimally invasive surgical techniques. Such operations have a number of advantages, including high efficiency and speed of the procedure, as well as painlessness, simplicity of preoperative preparation and a short rehabilitation period.

These techniques include infrared photocoagulation of hemorrhoids, which allows you to get rid of hemorrhoids without blood and does not require hospitalization in a surgical hospital.

What is the essence of infrared photocoagulation of hemorrhoids?

Infrared coagulation of hemorrhoidal cones is one of the most effective surgical minimally invasive methods for treating hemorrhoids.

For a short period of application, this procedure has gained popularity among patients, because the main advantage of the method is painlessness and speed of the procedure.

Literally after 24 hours of performing coagulation, the patient can return to his usual way of life, and the postoperative period proceeds easily and practically without complications.

The infrared coagulation method is considered relatively young. In 1978, physician proctologist Neiger began to practice coagulation of hemorrhoidal cones for the treatment of early stages of hemorrhoids. This technique has become quite popular among European specialists, who have significantly improved it.

The method is based on the local effect of infrared waves on the legs of the inflamed and enlarged hemorrhoidal veins of the rectum. Under the influence of heat rays in the tissues, the process of coagulation (coagulation) occurs, as a result of which the blood supply to the hemorrhoidal cone is disrupted, which gradually dies off and disappears.

The procedure is performed with a special apparatus - a coagulator, which consists of such elements as:

• electrical unit;
• hand gun applicator with hard LED coated with quartz;
• holder for the applicator.

When is infrared coagulation performed for hemorrhoids?

Infrared coagulation of hemorrhoidal cones is carried out only with combined or internal forms of hemorrhoids.

The indications for this technique are the following conditions:

• initial stages of hemorrhoidal disease (stages 1-2);
• hemorrhoids 1-2 stages, complicated by hemorrhoidal bleeding;
• the combined form of hemorrhoids 1-2 stages;
• rectal bleeding after unsuccessful ligation of hemorrhoidal cones with latex rings.

Infrared photocoagulation, treatment methods at MC Global clinic

Modern methods of treating hemorrhoids

What are the contraindications to infrared photocoagulation of hemorrhoidal cones?

Infrared coagulation of hemorrhoidal cones is categorically contraindicated in advanced forms of hemorrhoids complicated by purulent-inflammatory processes of the anorectal region.

The technique is not carried out in such cases as:

• without a clear line of separation of the process;
• running hemorrhoids (stages 3-4);
• tears of the anus and rectal mucosa;
• rectal fistulas;
• purulent inflammation of the soft tissues of the anorectal zone;
• inflammation of the rectal bowel;
• massive inflammatory process in the tissues of the small pelvis;
• anorectal thrombosis.

How to prepare for surgery?

At a preliminary consultation with a proctologist, a thorough examination is carried out, which includes the following methods:

• general clinical blood and urine tests;
• blood sugar test;
• Wasserman reaction;
• electrocardiography;
• chest fluorography;
• digital examination of the anus;
• anoscopy, and, if necessary, sigmoidoscopy or colonoscopy.

The day before the infrared coagulation procedure, the patient is advised to refuse heavy food (fried, fatty, spicy), as well as foods that cause flatulence.

On the day of the operation, the patient is given a cleansing enema or a laxative is prescribed the day before.

How is infrared coagulation of hemorrhoidal cones carried out?

Despite the fact that the operation is painless, unpleasant sensations may occur during the insertion of the dilators and the anoscope, so the procedure is performed under local anesthesia.

On the operating table, the patient takes a knee-elbow position. It is also possible to perform infrared photocoagulation on a proctological chair, on which the patient spreads his legs wide and presses them against the anterior abdominal wall.

The tissues of the perianal region are stretched to the sides with a dilator, and an anoscope with a lighting device is inserted into the rectal canal.

After that, a quartz LED is brought into the rectum to the leg and the process of coagulation of the cones is carried out directly, which is performed instantly (1-2 seconds). In the presence of large hemorrhoidal cones, the apex of the formation is also coagulated.

Basically, one node is coagulated in one procedure. But in rare cases, at most three hemorrhoidal cones can be eliminated at the same time.

If necessary, repeated photocoagulation is prescribed after 2 weeks. The course of treatment for hemorrhoids is from 1 to 6 operations.

How is the postoperative period?

The postoperative stage after infrared coagulation of hemorrhoidal cones does not require any therapeutic measures.

After the procedure, the patient is observed by a doctor for 2-3 hours and, in the absence of complications, is allowed to go home.

The patient can return to work 24 hours after the operation.

What complications can there be in the postoperative period?

Very rarely, patients experience complications in the form of pain, rectal bleeding, anorectal thrombosis and hemorrhoidal necrosis.

Pain syndrome is associated with the fact that hemorrhoids are located below the dentate line, where there are pain receptors. In this case, suppositories with anti-inflammatory and analgesic drugs are prescribed.

Anorectal thrombosis and hemorrhoidal necrosis is the result of prolonged and extensive photocoagulation.

To avoid complications in the postoperative period, it is necessary to carefully adhere to medical recommendations, as well as to entrust the procedure only to experienced specialists.

What is the effectiveness of infrared photocoagulation in hemorrhoidal disease?

Literally within two days after the operation, patients notice the cessation of hemorrhoidal bleeding and a significant decrease in hemorrhoids.

Within 5 years, there has been a renewal of hemorrhoids in every 8 patient who underwent infrared coagulation.

In advanced cases, infrared coagulation of hemorrhoids is ineffective, so other minimally invasive techniques or more radical operations are required.

What are the advantages of infrared coagulation of hemorrhoidal cones?

There are several advantages to this procedure:

• high efficiency in the treatment of early stages of hemorrhoidal disease;
• the speed of the procedure (7-15 minutes);
• painlessness;
• bloodlessness;
• simplicity of preoperative preparation;
• short and easy postoperative period;
• low risk of complications;
• low cost of the procedure.

What are the disadvantages of photocoagulation?

Infrared coagulation has several important disadvantages, namely:

• low efficiency in the treatment of stage 3-4 hemorrhoids;
• the occurrence of rectal bleeding when the node falls off;
• anorectal thrombosis and hemorrhoidal necrosis;
• impact solely on the consequences of the disease, and not on the cause.

How much does this treatment cost?

The cost of infrared coagulation of hemorrhoidal cones depends on the complexity of the case and the region of the country where the medical institution is located. On average, one procedure will have to pay from 3 to 7 thousand rubles.

Infrared coagulation of hemorrhoidal cones is a low-traumatic and painless procedure that is performed on an outpatient basis, does not require special training and, moreover, is inexpensive. But this technique has strict indications and will be ineffective for stage 3-4 hemorrhoids.

If you have ever had this operation, leave your feedback about it in the comments.

For coagulation of the leg, such a minimally invasive technique as infrared photocoagulation can be used, which is performed under the influence of a beam focused through a special light guide. In the future, the supply of the node stops, it dries out and is excreted naturally along with the feces.

Due to its simplicity and safety, infrared coagulation has become popular among doctors and patients. In our article we will tell you about the essence of this technique for treating hemorrhoids, its indications, contraindications, procedure, possible complications and results.

Coagulation of the leg of the hemorrhoid is carried out using a special device, an infrared coagulator. It consists of a power unit, a hard quartz fiber, and a tip made of a heat-resistant polymer material.

The instrument is equipped with a tungsten halogen lamp, which is housed in a gold-plated spherical reflector. The lamp creates a stream of infrared light that hits the reflector and focuses into the light guide. Then the beam hits the tissue of the hemorrhoid and is converted into heat energy, which provides cauterization of the tissues. The depth of coagulation can be adjusted by the time of exposure to the beam. For this, the doctor uses a timer that can be adjusted for a time interval from 0.5 to 3 seconds.

Indications for the procedure

Indications for infrared photocoagulation of hemorrhoids may be the following clinical cases:

• circular hemorrhoids in stages I-II, when the nodes are located at the level of the anorectal line;
• bleeding with internal hemorrhoids stage I-II;
• elimination of bleeding from small hemorrhoids after the ligation procedure with latex rings.

In the later stages of hemorrhoids, this method can only be used as an auxiliary manipulation to stop hemorrhoidal bleeding.

Contraindications

• combined form of hemorrhoids;
• III-IV stage of hemorrhoids;
• tendency to thrombosis or thrombosis of hemorrhoids;
• hemorrhoids, combined with concomitant pathologies of the rectum and anus: anal fissures, fistulas, paraproctitis, cryptitis, etc.

How is the procedure carried out?

Modern equipment provides new opportunities for the treatment of hemorrhoids.

To perform infrared photocoagulation, the patient is prepared for the procedure in the same way as for the ligation of the hemorrhoids. The session is performed on an outpatient basis.

The procedure for performing infrared photocoagulation:

1. The patient is placed on a gynecological chair in the "supine" position with legs thrown back on special supports. If necessary, in some clinical cases, the doctor may ask the patient to take the "lying on the side" or knee-elbow position.
2. An anoscope with a tube diameter of 18 mm and a length of about 6-8 cm is inserted into the anal canal, which is equipped with a special illuminating device. The device is positioned so that a node is visible in its lumen, which needs infrared photocoagulation.
3. The tip of the infrared coagulator is brought to the base of the assembly and placed on the mucous membrane. In this case, the tip is lightly pressed against the tissues of the leg of the node.
4. After that, the proctologist begins the photocoagulation procedure. To do this, it is cauterized at 3-4 points of the hemorrhoidal node leg, while retreating from each previous point at a distance of about 0.5 cm.The duration of the coagulation process depends on the size of the hemorrhoidal lump (1-3 seconds) and is determined by the doctor individually for each patient ...
5. After the completion of coagulation, the doctor removes the device from the anoscope and conducts a control examination of the nodes treated with infrared radiation.
6. The anoscope is carefully removed from the rectum.
7. The patient can get up from the gynecological chair and go home after receiving the doctor's recommendations about the necessary restrictions in physical activity and taking painkillers.

During all the manipulations, the patient does not feel significant pain. In one session, the proctologist can perform moxibustion on no more than three nodes. In the presence of multiple hemorrhoidal cones, a second procedure is performed, which is prescribed 12-14 days after the first.

Possible complications of the procedure

Immediately after performing correctly carried out infrared photocoagulation, the patient may experience minor discomfort and pain, which are not considered complications, go away on their own or are eliminated by taking non-narcotic analgesics.

Complications of the procedure develop with insufficient qualifications of the proctologist. These include the following conditions:

• severe pain syndrome, which developed due to the effect of the coagulator on the zones located below the scallop line;
• thrombosis of the nodes caused by too extensive area of ​​cauterization and the development of the inflammatory process;
• necrosis of the hemorrhoid site, provoked by an increase in the duration of coagulation and, in some cases, accompanied by minor bleeding.

All of the above complications are easily eliminated by symptomatic treatment.

results

After correct infrared coagulation of hemorrhoids, the patient stops:

• episodes of knot loss;
• bleeding from the rectum.

This minimally invasive method of treating hemorrhoids is especially effective in the initial stages of the disease, and at later stages it guarantees only a temporary result in the form of stopping bleeding.

Video on the topic "Infrared photocoagulation of hemorrhoids" (English):

Photocoagulation of hemorrhoids- This is a minimally invasive surgical procedure, during which, using a focused infrared beam, cauterization (coagulation) of the base of the node is performed at several points, which subsequently causes a violation of the blood supply and atrophy of the cavernous formation. The use of this method is justified in case of stage 1-2 internal hemorrhoids, including those accompanied by bleeding. The procedure is performed using an infrared coagulator inserted into the anal canal under the control of an anoscope. In one session of simultaneous coagulation, a maximum of three nodes are exposed. Immediately after the manipulation, the patient develops a feeling of discomfort, which completely disappears after 2-6 hours. In some cases, after photocoagulation of hemorrhoids, mucosal necrosis, bleeding, thrombosis of the node and recurrence of the disease (secondary hemorrhoids) are observed.

The cost of photocoagulation of hemorrhoids in Moscow

Manipulation has an affordable cost, it is widely used to treat the initial stages of hemorrhoids. Fluctuations in the price of the procedure in different clinics can be associated with the form of ownership, location and level of prestige of the medical organization, the qualifications of the operating surgeon, training in a medical institution, and the use of sedatives. In the presence of a large number of nodes and the need for repeated intervention, the price of photocoagulation of hemorrhoids in Moscow is calculated according to the formula “total cost of the first intervention minus the cost of preoperative examination”.

Infrared coagulation of hemorrhoids is one of the most popular surgical techniques, in which there is minimal intervention in the body without any injury to the tissues of the body. With this method, infrared rays are directly exposed to problem areas.

Infrared rays are supplied to the base of the hemorrhoid, due to heat coagulation occurs (adhesion, cauterization, combination of small particles). After a while, the node is depleted and disappears, as power ceases to flow to it. Sometimes, the atrophied hemorrhoid may fall off and be accompanied by slight bleeding.

The method of infrared coagulation of enlarged hemorrhoidal veins of the rectum with external hemorrhoids is not used.

The procedure is performed with a special apparatus - a coagulator. It consists of three elements:

• electrical unit;
• hand applicator gun with hard LED quartz with heat resistant polymer tip;
• gun holder.

The tool works as follows: a low-voltage lamp transmits a stream of infrared rays into a quartz optical fiber, which is directed to the assembly. Thanks to the polymer tip, the rays reach the intestinal mucosa without losing the power of light energy.

Indications for the procedure

Photocoagulation can be performed when hemorrhoids are located inside the rectum, external manifestations of hemorrhoids in the form of cones are usually treated with other methods of minimally invasive surgery.

The indications for this method of treating hemorrhoids are the following factors:

• the first two stages of the disease, which are complicated by bleeding from the rectum;
• combined form of hemorrhoids 1 or 2 stages;
• unsuccessful ligation (ligation of the knot with a special thread or latex ring).

pros

Minuses

1. Minimal blood loss. 2. The procedure is painless, fast, with a minimum rehabilitation period. 3. No special preparation is required, as is the case before surgery (for example, the use of drugs and injections for the effectiveness of anesthesia). 4. There are no scars and scars from the remote site. 5. Lack of general or local anesthesia during the operation. 6. The procedure is carried out without exposure to electric current, therefore, the likelihood of burns is excluded. 7. It is carried out without hospitalization, on an outpatient basis.

1. This procedure is not carried out in all clinics. 2. The likelihood of a relapse of the disease. 3. The procedure is carried out only on a paid basis. 4. If the coagulator is used incorrectly, there is a risk of thrombosis, severe pain in the anus, necrosis of the intestinal mucosa, intense bleeding. 5. For 14 days it is necessary to follow a slag-free diet. 6. Hemorrhoids of considerable size require more time for the procedure and several impacts on the node itself.

In some situations, coagulation of hemorrhoids is ineffective, therefore, other minimally invasive techniques should be used or a more radical method should be used - surgical intervention. Such a conclusion is made by the doctor, after a complete examination of the patient, studying his medical history and a final conclusion.

The cost of the procedure

The price for the infrared photocoagulation procedure depends on the region and the medical institution in which the operation is performed. On average, you need to pay from 2500 to 7000 rubles for one procedure. The cost of a proctologist's consultation and preliminary diagnostics should be added to the price of coagulation. In each hospital or medical center, the cost of diagnostic tests is completely different.

Conclusion

Methods for treating hemorrhoids with infrared rays are considered quite promising. They are less traumatic, painless and give quick results. However, such a minimally invasive method does not provide a complete guarantee of a cure for the disease. This is influenced by several factors: the professionalism of the doctor who performs the procedure, the correctness of the procedure, the stage of the disease.

After removing hemorrhoids, one must not forget about preventive measures that are aimed at improving blood circulation and strengthening the pelvic muscles.