The infrared coagulation is a non – surgical procedure with excellent results in treating the internal hemorrhoids. The therapeutic principle is represented by the action of fascicle with infrared radiations over the treated packet of hemorrhoids. The heat released produce thermo coagulation of the packet, through the local action of the vascular wall of the vein which aliments the hemorrhoids.
The procedure is minimum invasive, non surgical and can be done in the office with a minimal preparation of the patient. The time of a session of treatment with infrared: about 10 – 15 minutes and the patient can go home after the procedure. It is not necessary the anesthesia of the patient and there is no pain after the treatment session. The procedure can be repeated in 12 – 14 days in case that the patient needs a bigger number of packets with hemorrhoids which can not be treated simultaneously; it can be applied also for the pregnant women.
The hemorrhoids treatment through elastic ligatures
This method uses elastic bands applied on the internal hemorrhoidal packets. The procedure can be realized with a special applicator coupled to a vacuum cleaner, under videoproctoscope control. The elastic bands interrupt the circulation at the level of the treated hemorrhoid trigging the fibrosis process and the decrease of the hemorrhoidal mass. The use of the video proctoscopic assistance reduces the number of the sessions necessary for the entire elimination of the packets. The treated hemorrhoid will be eliminated, with the elastic ligature, in 2 – 7 days.
The procedure is not painful, does not need anesthesia and it realized with minimal preparation. The patient can return to his activities in a few hours. To increase the rate of success, it can be associated with an infrared coagulation session of the packets with hemorrhoids. For 1- 2 days, the patient can feel a local pain for which analgesics can be administrated. We recommend the avoidance of the constipation in the first days after the intervention. These procedures have a rate of success so big that the therapeutic surgical methods stay reserved strictly to the complicated cases or those which present associate lesions.
The conservative treatment of the anal fissure through injection with Dysport
Local injection with Dysport (botulinum toxin) to the patients with anal fissures has as effect the let – down of the under mucous muscles; the pain disappear and it allows the scar and the regeneration of the fissured mucous. The process starts in a few hours after the injection and it takes like two months, enough time for a complete recovery, without pain. This method has the best results especially in cases of the anal recent fissures. The cases with anal ancient fissures, chronic, associated with other affections as hemorrhoids can beneficiate of a treatment, but a proctologic consultation and a video proctoscopy can better specify if the conservative treatment is enough. The injection procedure it takes a couple of minutes and do not need surgery. This approch represents the only way of fast cure in these cases and can be a compulsory step before deciding the surgical treatment.
Eduard Ursuleanu, General Surgeon