THE ATRAUMATIC DEFINITIVE TREATMENT OF HAEMORRHOIDS

The definitive treatment of haemorrhoids is only achieved if the haemorrhoid is deprived of its blood supply. Various methods aimed at this result have been tried over time, such as the Logo Method, rubber band legation of haemorrhoid, sclerosing injections, laser shrinking, all of which time has shown to have failed to provide a definitive solution, while in some cases these have even caused serious problems.

Today the prevailing view, with which I fully agree, tends to be that the only two methods able to provide definitively solutions are surgical removal according to Milligan Morgan and the bloodless ligation of haemorrhoid vessels using Ultrasound Doppler technology. I opt for the bloodless method. Sometimes a combination of the open and bloodless methods is needed to achieve a better result.

LEGATION OF HAEMORRHOID VESSELS USING AN ULTRASOUND SYSTEM

The method is based on an ultrasound probe that is attached to the tip of an anoscope. The whole procedure is carried out in the operative theatre under sedation. The anoscope enters the rectum and is rotated until, the position, size and depth where the vessel is located is accurately pinpointed down to the millimetre. The device provides visual and acoustic signals due to the blood flow to it. Once the assistant has stabilized the anoscope, the surgeon using a semicircular needle sutures around the vessel, completely stopping the blood supply distally to the haemorrhoid. The result is immediately evident because, provided the suture is properly placed, the vessel's acoustic and visual signal stops completely.

By rotating the ultrasound anoscope, all the vessels are identified and ligated, the result being the virtually elimination of any chance of recurrence. The patient usually spends a night in the hospital, but he/she may also leave on the same day if he so desires provided he/she is willing to follow strict doctors orders. This method, despite being "non-traumatic" is not "magical"..! It requires at least a week's rest and avoidance of standing and straining. During this period patients may be mildly active. The need for painkillers is very limited and usually after ten days patients can return to work.

The method's advantages are that it is atraumatic and bloodless, complications of bleeding and narrowing are avoided, recovery is very quick, while at the same time the likelihood of recurrence is minimized.

✍️ By Elena Karafoka-Mavrou, GI SURGEON, Director of the Surgical clinic at, METROPOLITAN GENERAL with specialization in  stomach, colon, pancreas, small intestine, haemorrhoids, hernias and SURGICAL ONCOLOGY.