New Laser Treatments in Proctology

Lasers have recently been utilised in treating conditions such as haemorrhoids (piles), anal fistulas and pilonidal sinus disease. The principle is similar to the way lasers are used in treating varicose veins. A flexible laser fibre is used to deliver laser energy to treat conditions without the need for any incisions (cuts) to be made.

The laser used is a diode laser emitting 1470 nm wavelength. The technique has been gaining popularity and our experience started in 2016 and the best results have been in treating pilonidal sinus disease and anal fistulas.

LHP® (Laser Hemorrhoido-Plasty) – for haemorrhoids

The procedure is performed under general anaesthesia. Using a tiny 2mm cut, laser energy is used to shrink the haemorrhoidal tissues similar to varicose vein laser therapy. As the energy of the laser is inserted centrally into the haemorrhoid (pile) there is little or no damage to the lining of the back passage. . The part of the haemorrhoid (pile) that prolapses  (comes) out of the anus is stitched.

No part of the haemorrhoid (pile) is cut out and this results in less pain and quicker healing.

FiLaC® (Fistula-tract Laser Closure) – for anal fistulas

The procedure is performed under general anaesthesia. The fistula tracts may have drainage setons that have been previously placed. These setons are removed and the infected fistula tracts are destroyed by inserting the laser fibre to the tract and delivering energy to destroy the fistula tracts.

The key advantage of this minimally invasive technique is that it carries NO risk of damage to the sphincter (back passage muscle) and does not create open wounds that need daily dressing and packing by the district nurse and results in quicker recovery compared to other treatments.

PiLaC (Pilonidal sinus-tract Laser Closure) – for pilonidal sinus disease

PiLac treatment is a minimally invasive and new treatment for pilonidal disease using drainage setons and subsequent laser treatment. Conventional (current) treatment of pilonidal sinus involves cutting out all infected tissues in the natal cleft and stitching it together or leaving it open to heal. It is therefore not uncommon to have a wound that requires daily dressings by a nurse for weeks till it heals up. There is also a significant recurrence rate with conventional surgery.

PiLaC of laser treatment for pilonidal sinus disease is an excellent treatment without large wounds that require prolonged dressing and time off work. The treatment does however take longer as it requires two minor operations with a gap of a month at least but neither require more than a day or two off work and are well tolerated.