Can haemorrhoids be lasered?
Laser treatment of dilated vascular structures has long been proven in the treatment of varicose veins (varices). In proctology, haemorrhoid treatment with an 810 nm laser was first reported in 2009 by Hèlio Plapler at the University Hospital of Sao Paulo. The development of a fine, cone-shaped radiating glass fibre probe and the use of a waveform-optimised 1470 nm laser improved the effectiveness of the laser application.
Haemorrhoidoplasty (LHP) can be considered a mature therapy procedure today. In this procedure, the haemorrhoidal nodes are reduced in size and fixed from the inside with dosed laser energy. The Hemorrhoid Laser Procedure (HeLP), which only scleroses the afferent vessels at the base of the haemorrhoid, is even more restrained.
When the treatment-related swelling has subsided after one to two weeks, the haemorrhoidal nodes shrink and no longer tend to prolapse. This method can additionally be combined with gathering fixation sutures(HAL-RAR) if a pronounced prolapse is to be treated.
In other words, the dilation of the haemorrhoidal vessel (vascular component of haemorrhoidal disease) is treated with laser and the mechanical instability (prolapse component) is treated with suturing. These two therapeutic principles interact synergistically ("belt and braces principle").
What do I get out of it as a patient?
Statutory health insurance
Before you read on, you probably want to know whether the treatment costs are covered by health insurance. To date, the innovative treatment procedures with lasers are not included in the standard care.
The good news is that a whole series of statutory health insurers, predominantly from the group of company health insurance funds (BKKs), have now concluded contracts with us within the framework of integrated care (IGV). For the insured of these health insurance companies we can therefore offer a modern laser operation without additional costs for the patient. Information on the various modalities of reimbursement and assumption of treatment costs by health insurance can be found here.
A safe procedure with few complications
Our experience shows that laser haemorrhoidoplasty is a very safe and effective procedure, especially when compared to other haemorrhoid surgery techniques.
The individual steps of the treatment
Find out here what is important for the smooth course of treatment during laser haemorrhoid surgery. General information on outpatient rectal surgery can also be found on our page "Outpatient haemorrhoid surgery".
At your first appointment in our practice, you will tell us about the duration, type and intensity of your symptoms. The examination clarifies whether enlarged haemorrhoids are actually responsible for these symptoms. At least half of all patients who present with "haemorrhoids" are actually suffering from anal fissure or anal eczema independent of the rectum.
Is laser haemorrhoidoplasty the optimal procedure for you and your condition? In principle, haemorrhoids from I° - III° can be treated with it. In the case of individual, very large lumps, conventional haemorrhoid removal may be the method of choice.
If a patient has only few symptoms, it is sometimes possible to avoid surgery altogether and only treat symptomatically with stool regulation and ointment. In the case of very pronounced, circulating findings, a stapler haemorrhoidopexy (Longo operation) may be useful in individual cases.
Once these questions have been clarified, we will inform you about the expected impairments and possible, albeit rare, complications. The consultation ends with the signing of the written consent form for the operation.
For this purpose, you should visit the IATROS clinic a few days before the planned procedure or contact us by telephone, but at the latest one day before. Please bring the completed information/questionnaire with you. If possible, bring an interpreter with you if you do not feel confident in the German or English language.
When: Monday to Thursday from 9:00 to 17:00 and Friday from 9:00 to 13:00 without appointment. The IATROS clinic is closed on bridge days and public holidays.
Where? Joint practice for anaesthesia IATROS-KLINIK GmbH, Dr. med. Javier del Valle, Dr. med. Michael Kaspar, Dr. med. Christoph Schmitt-Hausser
Nymphenburger Straße 1, 80335 Munich, (high-rise building opposite Löwenbräu-Keller, U1/U7 Stiglmairplatz, tram line 22), Tel.: 089 - 461356-0
For further information, please visit the clinic's website at https://www.iatros-klinik.de/information/.
Even if you feel fully recovered after the procedure and the anaesthetic has worn off - we must not let you go home alone. Circulatory reactions or anaesthetic after-effects ("rebound") could put you in danger. You are therefore not allowed to go home alone, not even on public transport.
It is mandatory that an adult person picks you up at the Iatros Clinic. Please organise the pick-up reliably for the planned discharge date.
Be on time for the operation! As the duration of an operation can never be predicted with absolute certainty in advance, there may be delays in the start of the operation, we ask for your understanding.
In addition to haemorrhoidoplasty, haemorrhoid artery ligation with Recto-Analer Reconstruction (HAL-RAR) is also a promising therapy method that we use in our proctological center in Munich. The hemorrhoid nodes are not removed, but the arterial influx to them is prevented.
Hemorrhoidectomy is a conventional therapy method that is usually performed with an electric scalpel. In order to achieve even better results and accelerate wound healing, we recommend hemorrhoidectomy with laser instead of electrical scalpel.
Dr Hofer and Dr Bärtl are specialists in the treatment of haemorrhoids. Come to our proctology practice and let us advise you in detail. We are happy to be there for you.
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Poskus, T., Danys, D., Makunaite, G., Mainelis, A., Mikalauskas, S., Poskus, E., Jotautas, V., Dulskas, A., Jasiunas, E., & Strupas, K. (2020). Results of the double-blind randomized controlled trial comparing laser hemorrhoidoplasty with sutured mucopexy and excisional hemorrhoidectomy. International Journal of Colorectal Disease, 35(3), 481-490.
Proßt, R. (2019). Short- and long-term results after laser haemorrhoidoplasty. coloproctology, 41(6), 446-447.
Salfi, R. (2009). A New Technique for Ambulatory Hemorrhoidal Treatment. coloproctology, 31(2), 99-103.
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Weyand G, Theis CS, Fofana AN, Rüdiger F, Gehrke T. Laser haemorrhoidoplasty with the 1470-nm diode laser in the treatment of second- to fourth-degree haemorrhoidal disease - a cohort study of 497 cases.
Specialists in surgery, proctology
Brienner Str. 13, D-80333 Munich, Germany
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