OTHER PROCEDURES

RUBBER BAND LIGATION

Here a device is placed through the anoscope, which can pull up the redundant internal haemorrhoidal tissue and place a rubber band at its base. The band acts to cut off the haemorrhoid’s blood supply and it falls off (with the band) at roughly 5-7 days.

Disadvantage –

  • Sever pain persists for 24-48 hours of ligation.
  • More chances of secondary haemorrhage that is bleeding after the surgery.
  • Recurrence risk of 10-15%.
  • Contra-indicated in external haemorrhoids & thrombosed haemorrhoids.

INFRARED PHOTOCOAGULATION

Infrared coagulation (IRC) is another day-care basis procedure.IRC utilizes infrared radiation generated by a small light that is applied to the haemorrhoidal tissue. This energy is converted to heat and causes the haemorrhoidal tissue to become inflamed, slough off, and scar down, thereby eliminating this excess tissue.

Disadvantage –

  • Expensive apparatus
  • Multiple treatments may be required
  • Long term results are not as good as cryosurgery.
  • Can`t be performed in fourth degree, prolapsed, strangulated and thrombosed haemorrhoids.

SCLEROTHERAPY

Sclerotherapy is another out-patient based treatment for Grades 1 and 2 internal haemorrhoids. It involves the injection of chemical irritants into the haemorrhoids, resulting in scarring and shrinkage by reducing the blood vessels present in the haemorrhoidal tissues.

Disadvantage –

  • Recurrence is 15%
  • Not possible for externointernal, prolapsed or infected piles.
  • Slight faulty technique may lead to sloughing.
  • Contra-indicated in uncontrolled diabetes mellitus, ulcerative colitis & in pregnancy.

Hemorrhoidectomy

The entire haemorrhoid is cut and removed and the wound may be closed. The anal sphincter muscle is often cut (Lateral sphincterotomy) to reduce pain and facilitate wound healing.

Disadvantage –

  • Not suitable for anaemic patients and suffering from other systemic disorders.
  • Much painful.
  • Atmost care required in post-op period. If not causes sepsis and related complications.

Stapled Hemorrhoidectomy

A circular surgical stapler is used to cut and remove the haemorrhoids and inner layers of the anal wall and join the cut ends.









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