Treatment of Hemorrhoids

Dr. Roman, what are the biggest concerns and fears of patients when they come to your proctology practice, and what can you tell them?

First, it must be considered that the average period from the onset of the disease to the first visit to the doctor is about 5 years according to statistical studies. This already shows that it takes time for the patient to overcome the hurdle of going to the doctor. In most cases, bleeding in the stool is the trigger for the doctor's visit. The first fear of the patient is naturally colon cancer.

In reality, 90% of cases of anal bleeding are due to hemorrhoids and only 10% are due to malignant diseases. This should reassure patients, as in most cases hemorrhoids are the cause of their complaints, and we now have minimally invasive solutions available that are very painless, with recovery rates of over 60 to 70% just 2 or 3 days after surgery.

What treatment options can you recommend and why?

For several years, I have primarily performed minimally invasive outpatient surgeries. Since the laser represents the gentlest treatment option, it is my first choice compared to other "classic" techniques such as Ferguson or THD. In fact, patients are no longer admitted to the hospital but can go home on the evening of the surgery and even resume their normal activities on the same day. They have no dietary restrictions and can sleep at home. With increasing experience in treating hemorrhoids with the Leonardo diode laser, there is particularly noticeable postoperative patient satisfaction. The relationship between the proctological surgeon and the patient is traditionally very difficult when the surgeon sees the patient for a follow-up after a classic and very painful treatment after a week. The patient has suffered a lot and blames the doctor for their pain, despite all the empathy the doctor shows. With the Leonardo diode laser and its gentle technique, I no longer have this problem. I see satisfied patients, am pleased with how quickly they recover, and how little pain they have. Most patients have recovered by more than 60% after a few days.

Can you describe the exact procedure for laser treatment of hemorrhoids?

First, I would like to emphasize that this therapy is minimally invasive and therefore much gentler than the other, more traditional methods.

To insert the laser fiber behind the hemorrhoid, a small incision of about 1 to 2 mm (minimally invasive) is sufficient. This allows for low-pain treatment. The laser then "targets" the water molecules contained in the blood of the hemorrhoidal sac. The thermal effect reduces the hemorrhoidal sac and simultaneously ensures good hemostasis during the treatment of varicose veins in the anal canal. The effect of the laser reduces hypertrophic (excessive) varicose veins, it is a very gentle process and not very painful.

Additionally, we do not suture, as sutures are the main cause of postoperative pain.

What are the specific advantages of laser therapy?

The main reasons are firstly the much lower pain and secondly a faster recovery, which can be expected after just a few days.

The outpatient treatment and thus the possibility to go home on the evening of the surgery and eat without restrictions are also major advantages of laser therapy.

The special physiological properties of the therapy to reduce the hemorrhoidal mass also contribute greatly to the gentle nature of the treatment, and the absence of scars is partly responsible for the good recovery.

What experiences have you had with long-term results after laser treatment?

I have found that patients are always very satisfied when they have undergone this surgery. I have even used the laser for grade 4 hemorrhoids and also for hemorrhoidal prolapse and so far I have only had extremely positive results, good patient acceptance, and no negative consequences.

If there are fears among the more "classic" practitioners of burning the anal sphincter, I can guarantee that the sphincter is not touched, everything happens in the submucosa.

It is the local infiltration that protects the underlying tissue from the effect of the laser, and the laser beam can be directed exclusively at the hemorrhoidal package.

Book an appointment with Dr. Ionel Roman.