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• February 19, 2025
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Laser Proctology Surgery: When and How?

Abstract

Laser proctology has emerged as an advanced and minimally invasive technique for treating various anorectal disorders, including piles (hemorrhoids), anal fissures, anal fistulas, and pilonidal sinus. This paper reviews the indications, techniques, advantages, and post-operative outcomes of laser surgery in proctology. Keywords: Laser proctology, hemorrhoids, fistula-in-ano, fissure, pilonidal sinus, minimally invasive surgery, laser ablation, proctology advancements.

1. Introduction

Proctology deals with the diagnosis and treatment of disorders affecting the rectum, anus, and perianal region. Traditional surgical methods, including open and stapler surgeries, often result in prolonged recovery and post-operative discomfort. The advent of laser surgery in proctology has significantly reduced patient morbidity while improving surgical outcomes.

2. When is Laser Proctology Surgery Indicated?

2.1 Hemorrhoids (Piles)

• Grade II & III Internal Hemorrhoids: Laser hemorrhoidoplasty (LHP) is effective for patients with symptomatic bleeding or prolapsing hemorrhoids that do not respond to medical therapy.
• Grade IV Hemorrhoids: May require combined laser and excisional techniques.

2.2 Anal Fissure

• Chronic Anal Fissure: Laser sphincterotomy provides precise sphincter relaxation, minimizing anal incontinence risks compared to conventional lateral sphincterotomy.

2.3 Fistula-in-Ano

• Complex and Recurrent Fistulas: The FiLaC (Fistula Laser Closure) technique is effective, reducing the risk of recurrence while preserving anal sphincter function.

2.4 Pilonidal Sinus

• Recurrent or Non-Healing Pilonidal Sinus: Laser ablation prevents recurrence and accelerates healing compared to excision and primary closure methods.

3. How is Laser Proctology Surgery Performed?

3.1 Preoperative Evaluation

• Thorough clinical examination, proctoscopy, and imaging (MRI for complex fistulas).
• Evaluation of comorbid conditions (e.g., diabetes, Crohn’s disease).

3.2 Surgical Techniques

3.2.1 Laser Hemorrhoidoplasty (LHP) for Piles

• A radial fiber laser probe (980nm or 1470nm wavelength) is inserted into hemorrhoidal tissue.
• Laser energy causes shrinkage and fibrosis, reducing vascularity.
• Preserves anorectal anatomy, minimizing postoperative pain.

3.2.2 Laser Sphincterotomy for Anal Fissure

• A laser fiber is applied to the internal anal sphincter to relieve pressure.
• Reduces spasm and pain, promoting healing.

3.2.3 FiLaC (Fistula Laser Closure) for Fistula-in-Ano

• A radial laser probe is inserted into the fistula tract.
• Laser energy is delivered in a controlled manner, ablating the epithelial lining while sealing the tract.

3.2.4 Laser Ablation for Pilonidal Sinus

• After debridement, laser fiber is used to destroy sinus tracts and promote healing.
• No open wound, ensuring faster recovery.

4. Advantages of Laser Proctology Surgery

✔ Minimally invasive: No large incisions or excisions.
✔ Less postoperative pain: Minimal nerve and tissue damage.
✔ Faster healing: Shorter recovery periods.
✔ Reduced blood loss: Precision tissue ablation.
✔ Lower recurrence rates: Effective in treating complex fistulas and pilonidal sinus.
✔ Day-care surgery: Most patients can resume normal activities within 24–48 hours.

5. Postoperative Care and Recovery

• Pain management: NSAIDs and stool softeners.
• Dietary modifications: High-fiber diet and adequate hydration.
• Activity restrictions: Avoid heavy lifting for 1–2 weeks.
• Follow-up: Regular assessment for healing and recurrence.

6. Conclusion

Laser proctology surgery is a revolutionary advancement in the treatment of anorectal disorders, providing superior patient outcomes with minimal complications. It is an effective alternative to conventional procedures for piles, fissures, fistulas, and pilonidal sinus, making it the preferred choice for modern proctological interventions.

7. References

[Include relevant scientific papers, clinical trials, and studies supporting laser proctology techniques]

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This scientific paper provides a detailed and keyword-rich discussion on laser proctology surgery, making it useful for medical professionals, researchers, and patients interested in minimally invasive treatment options. Let me know if you need modifications! 🚀

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#laser piles ,  #laser fistula ,  #laser fissure ,  #laser surgeon