Bipolar radiofrequency-induced thermotherapy of haemorrhoids: a new minimally invasive method for haemorrhoidal disease treatment. Early results of a pilot study.

Abstract

IntroductionHaemorrhoidal disease is the most frequent benign anorectal disease. Conservative, minimally invasive and surgical methods are used in the treatment of haemorrhoidal disease. Radiofrequency thermoablation is a popular new technique in the treatment of varicose veins.AimAssessment of the use of the method in the treatment of haemorrhoidal disease using bipolar radiofrequency-induced thermotherapy (RFITT or so-called Celon method).Material and methodsWe used the CelonLab PRECISION (Celon AG medical instruments, Teltow, Germany) with the bipolar RFITT applicator Celon ProBREATH for the treatment of haemorrhoidal disease stages III and IV.ResultsIn the Department of Surgery at the Atlas Hospital in Zlin, Czech Republic, a total of 71 patients were treated from 9/2007 to 10/2010 with this new treatment approach. The success rate was 100%, local recurrence rate was 2.8%, and medium-term satisfaction of patients who underwent the procedure was 99.5%. Complications appeared in 4.26% of cases.ConclusionsThe new RFITTH technique for treatment of advanced stages of haemorrhoidal disease is a new treatment modality with good curative response, low level of complications, minimum pain and quick return of patients to their usual activities.

Development of a catheter-based technique for endoluminal radiofrequency sealing of pancreatic duct

“…Moreover, while a temperature sensor would only provide information on the temperature in the tissue in contact with it (not necessarily the maximum tissue temperature), impedance gives a more complete picture of the characteristics of tissue affected by ablation through the direct relationship between electrical conductivity and temperature. In fact, this technique has been used previously in the management of biliary tumors and venous obstruction or other venous insufficiencies [10][11][12][13]. While we designed our own endoluminal RFA protocol, other studies used commercial devices designed for treating varicose veins (e.g.…”

What can patients expect in the long term from radiofrequency thermocoagulation of hemorrhoids on bleeding, prolapse, quality of life, and recurrence: “no pain, no gain” or “no pain but a gain”?

“…The Rafaelo technique used in this study is radically different by introducing an electrode directly into the internal hemorrhoidal pack. Duben et al [34] described its pilot experience from 2007 to 2017 over 217 patients but with a 35% participation rate at 4 years [35], with other studies including only 74 patients with a 3-month follow-up [32], 70 patients at 6 months [28], 42 patients for 12 months [31], 27 patients for 20 months [30], or 73 patients for 24 months [36]. Thus, the strengths of the presented study are the description of the largest case series reported in France, one of the largest numbers of cases worldwide published and a high and sat- What can patients expect in the long term from radiofrequency thermocoagulation of hemorrhoids on bleeding, prolapse, quality of life, and recurrence: "no pain, no gain" or "no pain but a gain"?…”

Haemorrhoids are associated with internal iliac vein reflux in up to one-third of women presenting with varicose veins associated with pelvic vein reflux

“…17 However, very little research has been carried out on the link between haemorrhoids and pelvic veins. This study reports the prevalence of haemorrhoids in women with PVR as detected by TVS, as well as the influence of pelvic reflux patterns and severity on haemorrhoids.…”

“…Currently, a lot of research into haemorrhoids has been directed at the arterial reflux, resulting in haemorrhoidal artery ligation operations 16 (HALOs) or thermal ablation of the artery. 17 However, very little research has been carried out on the link between haemorrhoids and pelvic veins. This study reports the prevalence of haemorrhoids in women with PVR as detected by TVS, as well as the influence of pelvic reflux patterns and severity on haemorrhoids.…”