Infrared photocoagulation of hemorrhoids
Content of method:
The coagulator is applied to mucosa at the pedicle of hemorrhoid. Thermal energy affects at the apex of column and determines desolation and adhesion of vessels, which supply hemorrhoid.
Technique of infrared photocoagulation:
For coagulation, we use infrared photo coagulator. The tip of a probe is fitted with a quarz crystal that focuses the rays of an infrared bulb. It has timer which regulates the duration of influence of thermal stream (0,5 – 3,0 sec.).
Infrared light stream penetrates tissue of hemorrhoid and there it turns into thermal energy, and this way coagulates tissue. The depth of coagulation depends on the duration of influence. The indication for infrared photocoagulation is internal bleeding hemorrhoid first- and second degree and circumferential composite hemorrhoid first- and second degree (if internal hemorrhoid locates at the level of anorectal line). This method also applies for residual small bleeding hemorrhoid (after rubber legation or hemorrhoidectomy).
The procedure can be applied in the jack-knife, lithotomy or knee-elbow position of patient. For this technique, there is introduced anoscope (length 6-8cm, diameter 18mm), lighter and source of light. Anoscop is inserted in anal canal the way that hemorrhoid would be prolapsed in the rift of anoscop. The tip of infrared photocoagulator is inserted in the rift of anoscop and localized in projection of the hemorrhoidal pedicle. And after this it’s possible to start coagulation. Ordinarily, the coagulator is applied to four sites on each column (distance between points 5mm). Duration of coagulation depends on size of hemorrhoid (1-3sec)