“Large laser sclerotherapy” particularly suitable for haemorrhoids grade 3-4, a completely new procedure that does not require large incisions. The laser probe is inserted directly into the enlarged haemorrhoidal nodules through only 4 stitches and these are shrunk by photocoagulation. Attached external haemorrhoids or wrinkles are removed with the laser at the end of the operation, when their size has already reduced. Immediately after the operation, a temporary painless swelling of the treated hemorrhoidal tissue may occur. Sometimes the shrinkage of the anal skin over the photocagulated hemorrhoid pads leads to anal wrinkles, which are later removed under local anesthesia.
The currently most gentle procedure for the treatment of higher grade haemorrhoids has only been used since 2006. No long-term results are yet available. My own results show an apparently equivalent long-term effect to that of forklift hemorridopexy. Except for very large internal prolapse. For patients with such a large internal prolapse, I still consider a resecting procedure such as stacker hemorridopexy after Longo to be the better surgery.
For all other patients with grade 3-4 hemorrhoids, LHP represents a revolution in hemorrhoid treatment. The sensitive anoderm is spared to the maximum extent possible without scars forming there. There are also no circular scars in the rectum, as in stacker hemorrhoidopexy.
The pain after the operation is significantly lower compared to conventional surgical methods (level 5 according to the 10-step pain scale in maximum on the first day of surgery). The resumption of work is much more likely after an average of 7 days (compared to 3 weeks). I have already had patients who were back at work after 1-3 days.
Patients with statutory health insurance are treated as inpatients.
For privately insured patients, the health insurance company covers the costs of both outpatient and inpatient surgery.