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Haemorrhoid removal with laser

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Info flyer anal fissure

Sustainable and proven

Haemorrhoid surgery with laser: haemorrhoidectomy

Removal of haemorrhoids through surgery is called haemorrhoidectomy in technical language. The surgeon cuts around the outer part in an arc and detaches the enlarged haemorrhoid from the inner sphincter muscle. Careful dissection with a laser spares the muscle. A Z-shaped suture (ligature) cuts off the feeding blood vessels. This operation is also called the Milligan-Morgan operation after the first surgeons to describe it, St. Marks.

Usually, the surgeon uses an electric scalpel for haemorrhoid surgery. For this procedure in our proctology practice, we rely on the extraordinary precision of a laser with a wavelength of 980 nm(Intros Lina 30). This results in smoother incision edges, earlier wound healing and reduced pain and swelling.

Dr. Hofer explains haemorrhoid removal with laser on a model
Model rectum with enlarged haemorrhoids

A distinction is made between closed haemorrhoidectomy with suturing of the wound (operations according to Ferguson, Parks or Fansler-Arnold) and haemorrhoidectomy in which the wound remains open. After numerous studies convincingly show that suturing does not provide any benefits in terms of pain and healing time, we prefer not to do it. It is not uncommon for the sutures to tear out anyway in the delicate tissue of the anus. For this reason, we seal the wound edges with laser instead and thus avoid bleeding.

The laser haemorrhoidectomy is always worth considering in these cases if

  • only single hemorrhoid nodes are present
  • these cannot be pushed back into the anus or cannot be pushed back completely into the anus
  • the accompanying skin growths (mariscae) are so disturbing that they should also be removed
  • an accompanying anal fissure must be operated on

Precise and effective

Hemorrhoid surgery procedure and aftercare

We operate on an outpatient basis and under anaesthesia (general or spinal). Our surgery day is every second Friday afternoon. The operations take place in the Iatros - Clinic, an outpatient surgery center. After the operation you will be monitored in the recovery room for 1 - 2 hours. Then you can be picked up again.

You will receive the prescription for necessary medication on the day of the surgery, as well as a mobile number for urgent matters at the weekend. I will bring you the necessary certificate of incapacity for work on the day of the operation. Most patients are on sick leave for 2 - 3 weeks after a haemorrhoidectomy.

Significant afterpains (dampness, wound pain) are to be expected until the second week after the operation. Once the healing has begun after this time, it goes steadily noticeable uphill.

Aftercare after hemorrhoid surgery is not demanding:

  • Stool regulation with psyllium husks or macrogol
  • Cleaning the anal region with the shower or in a sitz bath at a comfortable temperature
  • Generous administration of painkillers
  • Wearing a panty liner / sanitary napkin to absorb the wound secretion
  • if necessary, application of hydrocolloid gel
  • if necessary, application of local antibiotic ointment preparations (metronidazole-vaseline)
  • If necessary, promotion of wound healing and pain reduction by Low Level Laser (LLLT)

Sphincter injury does not occur when performed properly. Sensitivity in the anal area is best protected if sufficient sensitive anal skin is left behind. Scarred constrictions of the anus are very rare consequences, as are significant restrictions in the ability to hold stool (incontinence).

In our proctological practice in Munich, we also use laser haemorrhoidoplasty or haemorrhoid artery ligation. We will be happy to advise you in detail on all therapy options - do not hesitate to contact us.

Removal of "external haemorrhoids

Should skin folds (marisques) and anal vein thrombosis be surgically removed?

  • "Acute external haemorrhoids" are mostly anal vein thrombosis and heal on their own. The wound resulting from removal would take longer to heal than the anal thrombosis. We therefore recommend symptom-oriented therapy with painkillers, stool regulants, decongestant ointments and LLLT.
  • skin folds (marisques) may bother for various reasons. Many patients come with the desire to get rid of the annoying growths. However, wound pain and healing time argue against surgical intervention. The resulting scars can sometimes be more functionally disturbing than the marisk before (loss of elasticity, loss of sensitivity, stool smearing). We therefore adviseagainst the removal of marisques . In the area of statutory health insurance, we are also bound by the principle of economic efficiency. Only absolutely necessary treatments are covered by the health insurance.

Literature Haemorrhoid Removal

  1. Trompetto, M., Clerico, G., Cocorullo, G. F., Giordano, P., Marino, F., Martellucci, J., Milito, G., Mistrangelo, M., & Ratto, C. (2015). Evaluation and management of hemorrhoids: Italian society of colorectal surgery (SICCR) consensus statement. Techniques in coloproctology, 19(10), 567-575. https://doi.org/10.1007/s10151-015-1371-9

DR. BERNHARD HOFER, FLORIAN LIEBL & COLLEAGUES

Specialists in surgery, proctology

Brienner Str. 13, D-80333 Munich, Germany