A New Technique for Ambulatory Hemorrhoidal Treatment

Background and Purpose: A new technique for the treatment of hemorrhoids is described using a 980-nm diode laser coupled with Doppler for photocoagulation of the distal branches of hemorrhoidal arteries. This painless, ambulatory treatment does not necessitate anesthesia or sedation and is based on the same principles as Doppler-guided ligation of the distal branches of hemorrhoidal arteries, a recent, innovative technique for the treatment of hemorrhoids achieving good results. Unfortunately, the latter technique requires local, general or epidural anesthesia, and ambulatory treatment is difficult. Patients and Methods: In the past 3 years, 200 patients were treated with Dopplerguided laser photocoagulation of hemorrhoidal arteries. In all cases, treatment was performed on an outpatient basis and anesthesia or analgesia was not necessary. Results: Mild intra- and postoperative complications were seen. 91% of the patients showed an improvement of hemorrhoidal symptoms 1–12 months after treatment. Conclusion: Doppler-guided laser photocoagulation of hemorrhoidal arteries is a good and safe method for the ambulatory treatment of hemorrhoids.