About Laser Piles Surgery

The methodology is classified as a surgical method that uses a laser beam to cure haemorrhoids. A specialised device emits intense light energy to shrink or eliminate the affected tissue. This high-intensity light causes the tissue to vaporise or coagulate, reducing size.

Piles laser treatment is usually outpatient (patients are generally discharged within 24 hours or the same day), with local or general anaesthesia. The devices precision targets only the affected tissue, minimising harm to healthy tissue.

Anatomy of Anus

To understand laser piles surgery, it is essential to know the anatomy of the anus. Information regarding the anus helps in gaining knowledge about the positioning of haemorrhoids.

The basic anatomical structure of the anorectal region includes:

1. Rectum: The last section of the colon serves as a temporary storage for stool before it is expelled. This section is connected to the sigmoid colon and stretches to the anal canal.
2. Anal Canal: The end of the rectum, which serves as a brief pathway that terminates at the anus, is called the anal canal. It measures approximately 3–4 cm long and is encompassed by muscles responsible for regulating bowel movements and ensuring faecal control.
3. Haemorrhoidal Tissue: Clusters of blood vessels can be found in the anal canal; this vascular system is called piles cushions (haemorrhoidal tissues). This vascular system plays a role in both maintaining faecal continence and assisting in the regulation of gas release.
4. Anus: This is where waste material is stored in the body. It consists of two muscular rings – the internal anal sphincter, which operates involuntarily, and the external anal sphincter, which serves voluntarily. These muscles help maintain anal tone and control bowel movements.
5. Perianal Skin: The anal region is encompassed by the skin. This area is prone to itching, rashes, and infections.

Piles Conditions Treated with Laser Surgery

Laser surgery is a less-invasive outpatient procedure that uses a fine energy beam to remove the tissue from the surrounding area. The treatment is considered an ideal solution for piles grade II-IV. The characteristics of such haemorrhoidal conditions are-

1. Grade II: The piles may protrude or exit the anus during bowel movements but will return to their initial position.
2. Grade III: The piles prolapse during bowel movements and require manual pushing back afterwards.
3. Grade IV: In this case, the piles will consistently be prolapsed and cannot be manually retracted. Grade IV piles keep protruding out of the anus and cause excessive discomfort to the patient.

Apart from the treatment of haemorrhoids based on the grade of severity, Laser Haemorrhoidectomy can also treat various types of piles based on their location.

1. External Piles: Small protrusions that develop beneath the skin surrounding the anal area. They cause intense itching and discomfort. Typically, bleeding accompanies this condition.
2. Internal Piles: The lumps form inside the rectum and are typically not detectable through an external examination. Some bleeding may be observed during bowel movements, but they rarely result in pain or discomfort.
3. Prolapsed Piles: Prolapse is a condition where internal and external piles stretch and bulge outside the anus. This can result in bleeding or intense pain.
4. Thrombosed Piles: Haemorrhoidal thrombosis occurs when a blood clot forms in the anal veins. It typically appears as a firm swelling on the anus, causing discomfort when touched or sitting.

Who needs laser piles operation?

For haemorrhoids patients, laser piles treatment eliminates the haemorrhoidal tissue or interrupts the blood vessels, causing overall discomfort.

The proctologist will determine the appropriate treatment for haemorrhoids and prolapsed haemorrhoids based on the severity of the condition. The treatment selection criteria include aspects like:

1. Persistent Symptoms: Patients with persistent and severe piles symptoms may be advised to undergo laser treatment. This procedure targets the haemorrhoidal tissue to provide relief.
2. Recurrent Haemorrhoids: Laser haemorrhoidectomy is an effective treatment option for individuals with recurrent symptoms such as discomfort, bleeding, and anal-rectum pain. It can help prevent future recurrences.
3. Severe Haemorrhoids: For individuals with grade II-IV piles that significantly affect their quality of life, laser surgery is an appropriate treatment option. This includes large, internal, external or prolapsed haemorrhoids.
4. Resistance to Usual Methods: If conservative treatments (home remedies and medications) have not relieved the haemorrhoids symptoms, Laser Haemorrhoidectomy is recommended for a more effective and long-lasting solution.

Piles Laser Treatment Benefits

Laser surgery is popular for piles treatment due to its multiple benefits. It is a reliable and preferred medical procedure.

Some of the prominent advantages of piles laser treatment include:

1. Minimally Invasive: Piles laser treatment is the least intrusive procedure that uses a laser to remove affected tissue. It offers smaller incisions, less bleeding, and quicker healing than open surgery.
2. Reduced Pain: Using laser energy to seal blood vessels during the procedure reduces postoperative pain and swelling. This results in a quicker recovery, allowing patients to resume normal activities sooner.
3. Improved Accuracy: Utilising a specialised energy beam in surgery enables surgeons to target and remove affected tissue with precision. This leads to more effective treatment and better patient outcomes. It also minimises complications.
4. Faster Recovery Time: The technique offers quicker recovery times than traditional methods. Patients spend less time in the hospital and can return to daily activities within 1-2 weeks (depending on the patient's condition).
5. Minimal Scarring: Laser piles treatment leaves minimal scarring since it involves small incisions. This is especially beneficial for individuals who are concerned about cosmetic outcomes.
6. Reduced Risks: This medical procedure has lower complication risks than traditional methods. The precise laser treatment targets the affected area, reducing damage to surrounding tissues and minimising infection risk.
7. Outpatient Procedure: Laser haemorrhoidectomy is often done on an outpatient basis, allowing patients to go home the same day. This saves time and money for patients.
8. Customisable Treatment: The surgery is customisable, with doctors adjusting the laser intensity and wavelength to each patient's needs. This personalised approach leads to better outcomes.

Before and On the Day of Piles Laser Operation

Patients must undergo a thorough evaluation before the laser piles operation procedure to determine eligibility for the process. However, the following can be expected before and even on the day of the procedure.

Patients must undergo preparations and assessments to ensure a smooth and successful procedure. A thorough evaluation is crucial to determine surgery eligibility.

The clinical procedure before a laser surgery includes-

1. Pre-operative Assessment: The proctologist will conduct blood tests and physical examinations to assess the patient's overall condition and suitability for surgery.
2. Proctoscopy: Healthcare professionals will examine the inside of the anal region using a proctoscope and feel the haemorrhoids with a lubricated finger.
3. Anaesthesia Selection: The doctor will ensure that the patient meets the anaesthetist to assess their fitness for surgery and ensure their safety during the procedure.
4. Medication Risks Analysis: Consult the proctologist about any medications that may interfere with the procedure. If prescribed, take them with a small amount of water.
5. Fasting: Patients should fast 6-8 hours before surgery to prevent anaesthesia-related complications.

On the Day of Surgery

1. Fasting: About 8 hours of fasting before the surgery may be required.
   This is to ensure your stomach is empty and reduce the risk of complications during anaesthesia influence.
2. Medications: The surgeon may instruct the patient to take specific medications on the day of surgery.
   However, any medications should be avoided unless explicitly approved by the surgeon.
3. Clothing: Wearing loose and comfortable clothing in the surgical facility is essential.
   This can help with comfort and make it easier for medical staff to prepare for the procedure.
4. Preparation: The patient will be taken to a preoperative area, where medical staff will prepare them for surgery.
   This might involve monitoring the vitals.
5. Anaesthesia: Administration of anaesthesia will be done before the procedure. The type of anaesthesia will depend on the surgeons recommendation and medical history.

How is laser haemorrhoidectomy performed?

Laser pile surgery is a minimally invasive procedure that takes approximately 20 to 30 minutes, usually depending on the patients age, other medical conditions, and the severity of the disease.

The laser beam destroys the swollen haemorrhoids, causing pain and bleeding. The procedure is also usually performed under anaesthesia to keep the patient comfortable. The following steps are taken during the process:

1. Anaesthesia Administration: Before the surgery, the surgeon will give the patient general or local anaesthesia. It will numb the anal area and keep the patient awake during the operation.
2. Patient Positioning: The patient will be asked to lie in a lithotomy position, which means lying on their back with their knees bent and legs supported. This position helps the surgeon access the anal area more easily.
3. Proctoscopy: The surgeon will gently insert a tube called a proctoscope into the anus. This tube has a special probe that helps locate the blood vessels supplying the haemorrhoids.
4. Laser Emission: Once the artery is found, the surgeon will insert a laser fibre into the anus through the same tube. Laser shots will be applied to destroy these arteries.
5. Haemorrhoids Shrinkage: Laser energy cuts off the blood supply to shrink the condition. This process typically takes about six weeks, reducing them to 60-80% of their original size.

Cost of Piles Laser Surgery

The piles laser treatment cost ranges from ₹ 35,000 to ₹ 1,10,000. The price varies based on the following factors:

1. Consultation Fee: Before undergoing surgery, it is crucial to understand the procedure, risks, and benefits. Consultation with a skilled doctor is highly recommended, although it may increase the overall cost.
2. Surgeons Fee: Laser haemorrhoidectomy is a specialised procedure that requires an experienced and well-equipped surgeon. The surgeons expertise and experience can increase the cost of the piles laser operation.
3. Admission Fee: Laser treatment for piles is a daycare procedure requiring hospital admission, which affects the total surgery cost in India.
4. Patients Age: Piles can affect people of all ages. Older patients may experience more complications during surgery, which can impact the cost of the laser piles operation.
5. Patients Medical Condition: Patients who are elderly or have a weakened immune system require additional attention, affecting the cost of their laser treatment.
6. Type of Hospital: Hospitals and clinics typically provide the standard procedure of laser piles operation. The overall cost can vary depending on the hospital chosen.
7. Location or City: The cost of laser treatment for piles in India may vary based on the hospitals site. Generally, metro cities have higher prices than smaller and more remote towns.
8. Diagnostic Test Cost: Patients must undergo diagnostic examinations like digital rectal examination, sigmoidoscopy, and colonoscopy before laser surgery. The cost of these tests affects the total expense of pile surgery in India.
9. Post-Surgery Complications: Complications from laser treatment for piles can occur. The cost of treating these complications is included in the overall operation expenses.

Takeaway

Laser treatment for piles is a safe and effective option. It provides pain relief, promotes healing, and prevents recurrence. This minimally invasive procedure offers faster recovery, improved quality of life, and reduced risk of complications.