46930 Destruction of internal hemorrhoid(s) by thermal energy (eg, infrared coagulation, cautery, radiofrequency)

Name of the Procedure:

Destruction of internal hemorrhoid(s) by thermal energy

• Common Names: Thermal hemorrhoid treatment, Infrared coagulation, Cauterization, Radiofrequency ablation of hemorrhoids

Summary

In this procedure, internal hemorrhoids are treated using thermal energy like infrared light, cautery, or radiofrequency, which causes the hemorrhoidal tissue to shrink and recede. It is a minimally invasive technique aimed at providing relief from hemorrhoid symptoms.

Purpose

• Medical Condition: Internal hemorrhoids
• Goals: To reduce or eliminate hemorrhoids, relieve symptoms such as bleeding, discomfort, and itching, and improve patient's quality of life.

Indications

• Symptoms: Persistent bleeding, pain, itching, or prolapse of internal hemorrhoids.
• Patient Criteria: Patients who have not responded to conservative treatments (e.g., dietary modifications, topical treatments) or those who seek a less invasive option compared to surgery.

Preparation

• Pre-Procedure Instructions: Patients may be advised to perform an enema or take a laxative to clear the bowels. Fasting for a few hours before the procedure may be required.
• Diagnostic Tests: Physical examination, possibly anoscopy to visualize hemorrhoids.

Procedure Description

1. The patient is positioned to provide access to the anal area.
2. Local anesthesia might be applied to numb the area.
3. An anoscope is inserted into the anus to visualize the hemorrhoids.
4. Thermal energy (infrared light, cautery, or radiofrequency) is applied to the base of the hemorrhoids.
5. The heat causes the hemorrhoidal tissue to coagulate and shrink.
6. The instrument is removed, and the patient is monitored briefly for any immediate complications.

Duration

Typically takes about 10-20 minutes per session.

Setting

• Location: Outpatient clinic, surgical center, or hospital.

Personnel

• Healthcare Professionals: The procedure is usually performed by a proctologist or a general surgeon, assisted by nurses.

Risks and Complications

• Common Risks: Discomfort, pain, slight bleeding post-procedure.
• Rare Risks: Infection, excessive bleeding, ulceration, and recurrence of hemorrhoids.

Benefits

• Provides symptomatic relief from hemorrhoidal discomfort, bleeding, and itching.
• Minimally invasive with quick recovery time and high success rates.
• Benefits typically realized within a few days to a week post-procedure.

Recovery

• Post-Procedure Care: Patients may be advised to avoid strenuous activities for a few days. Over-the-counter pain relievers might be recommended.
• Recovery Time: Generally quick; most patients return to normal activities within 1-2 days.
• Follow-Up: Patients may need follow-up visits to assess the success of the treatment or additional sessions.

Alternatives

• Treatment Options:
  • Conservative treatments like dietary changes, topical ointments, and sitz baths.
  • Other minimally invasive procedures like rubber band ligation, sclerotherapy.
  • Surgical options such as hemorrhoidectomy.
• Pros and Cons: Each alternative varies in terms of invasiveness, recovery time, and the risk of complications. Surgery is more invasive but may be more effective for severe cases.

Patient Experience

• During the Procedure: Patients might feel slight discomfort or a warming sensation but should not experience significant pain.
• After the Procedure: Mild discomfort and slight bleeding are normal. Pain is usually manageable with over-the-counter medications. Patients are advised to maintain good hygiene and follow post-procedure care instructions to aid in recovery.