Evaluation of a Minimally Invasive Bipolar Coagulation System for the Treatment of Grade I and II Internal Hemorrhoids

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Adam Studniarek ◽  
Saleh Eftaiha ◽  
Christina Warner ◽  
Sany Thomas ◽  
Timothy P. Johnson ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Coagulation System ◽  
Bipolar Coagulation ◽  
Internal Hemorrhoids

Prospective Case Series of a Novel Minimally Invasive Bipolar Coagulation System in the Treatment of Grade I and II Internal Hemorrhoids

2016 ◽  
Vol 23 (6) ◽  
pp. 581-585 ◽  
Author(s):  
Benjamin P. Crawshaw ◽  
Andrew J. Russ ◽  
Bridget O. Ermlich ◽  
Conor P. Delaney ◽  
Bradley J. Champagne
Keyword(s):  
Minimally Invasive ◽  
Rubber Band Ligation ◽  
Case Series ◽  
Rubber Band ◽  
Dentate Line ◽  
Additional Treatment ◽  
Coagulation System ◽  
Recurrent Bleeding ◽  
Internal Hemorrhoids ◽  
Prospective Case Series

Background. Existing nonsurgical procedures for the treatment of grade I and II internal hemorrhoids are often painful, technically demanding, and often necessitate multiple applications. This study prospectively assessed the safety and efficacy of the HET Bipolar System, a novel minimally invasive device, in the treatment of symptomatic grade I and II internal hemorrhoids. Methods. Patients with symptomatic grade I or II internal hemorrhoids despite medical management underwent hemorrhoidal ligation with the HET Bipolar System. Endpoints included resolution or improvement of hemorrhoidal bleeding and/or prolapse from baseline, recurrent or refractory symptoms, and pain. Results. Twenty patients were treated with the HET Bipolar System. Two were lost to follow-up. Refractory or recurrent bleeding was present in 8 of 18 (44.4%), 4 of 11 (36.4%), and 4 of 8 (50.0%) patients, and prolapse was reported by 1 of 18 (5.6%), 4 of 11 (36.4%), and 1/7 (14.3%) of patients at 1, 3, and 6 months, respectively. Bleeding improved from baseline in 88.2%, 81.8%, and 87.5% of patients, and resolution of baseline prolapse was seen in 11 of 11 (100%), 4 of 7 (57.1%), and 5 of 5 (100%) patients at the same intervals. Thirteen of 18 (72.2%) patients did not require additional treatment for their symptoms. Conclusions. The HET Bipolar System is safe and easy to use with short-term effectiveness comparable to that of currently used techniques for the treatment of symptomatic grade I and II internal hemorrhoids. It may be an effective alternative to rubber band ligation in patients with larger internal hemorrhoids and those with hemorrhoids close to the dentate line in which banding may produce debilitating pain.

scholarly journals Treatment of Internal Hemorrhoids by Endoscopic Sclerotherapy with Aluminum Potassium Sulfate and Tannic Acid

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Yuichi Tomiki ◽  
Seigo Ono ◽  
Jun Aoki ◽  
Rina Takahashi ◽  
Shun Ishiyama ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Tannic Acid ◽  
Internal Hemorrhoid ◽  
Potassium Sulfate ◽  
Endoscopic Sclerotherapy ◽  
Normal Position ◽  
Minimally Invasive Approach ◽  
Invasive Approach ◽  
Internal Hemorrhoids ◽  
Mild Fever

Objective. A new sclerosing agent for hemorrhoids, aluminum potassium sulfate and tannic acid (ALTA), is attracting attention as a curative treatment for internal hemorrhoids without resection. The outcome and safety of ALTA sclerotherapy using an endoscope were investigated in the present study. Materials and Methods. Subjects comprised 83 internal hemorrhoid patients (61 males and 22 females). An endoscope was inserted and retroflexed in the rectum, and a 1st-step injection was applied to the upper parts of the hemorrhoids. The retroflexed scope was returned to the normal position, and 2nd–4th-step injections were applied to the middle and lower parts of the hemorrhoids under direct vision. The effects of endoscopic ALTA sclerotherapy were determined by evaluating the condition of the hemorrhoids using an anoscope and interviewing the patient 28 days after the treatment. Results. A cure, improvement, and failure were observed in 54 (65.1%), 27 (32.5%), and 2 (2.4%) patients, respectively, treated with ALTA. Complications developed in 4 patients (mild fever in 3 and hematuria in 1). Recurrence occurred in 9.6%. Conclusions. The results of the present study suggest that endoscopic ALTA has the potential to become a useful and minimally invasive approach for ALTA sclerotherapy.

scholarly journals Application of rubber band ligation as a treatment of internal hemorrhoids

2021 ◽  
Vol 9 (8) ◽  
pp. 2235
Author(s):  
Sevil Ozer Sari ◽  
Coşkun Yıldız
Keyword(s):  
Minimally Invasive ◽  
Low Cost ◽  
Laboratory Data ◽  
Rubber Band Ligation ◽  
Treatment Method ◽  
Rubber Band ◽  
Invasive Treatment ◽  
Band Ligation ◽  
Internal Hemorrhoids ◽  
Procedural Success

Background: Aim was to more than three-quarters of the whole population will experience complaints of hemorrhoids at some point in their lifetime. The treatment of internal hemorrhoids includes medical, minimally invasive and surgical treatments. The aim of the study was to evaluate the data of patients who were applied with rubber band ligation (RBL) as a minimally invasive treatment method of internal hemorrhoids.Method: The study conducted in the gastroenterology department of Izmir Tepecik training and research hospital between December 2015 and December 2019. Demographic and laboratory data of the patients, the success and the complications rates of the procedure were evaluated retrospectively .Results: Evaluation was carried out  in 45 consecutive patients, comprising 23 (51.1%) females and 22 (48.9%) males with a mean age of 54.62±7.82 years (range, 40-82 years). Procedural success rate was 91.1% and failure of treatment was seen in 8.9% of the patient. Recurrence rate of RBL procedure determined with control rectoscopy was found as 5.26% at 1 year follow-up. No major complications developed in any patient. Significant correlation was determined between the development of bleeding and the use of anticoagulants and anti-aggregants (p=0.003). No significant relationship was seen between the number of band ligation procedures and the development of complications (p=0.275).Conclusions: The application of RBL, which is widely used in the treatment of internal hemorrhoids, is a reliable and low-cost method that shortens the length of stay in hospital, which can be preferred in patients with high comorbidity risk for surgery. 

scholarly journals Successful Management of Giant Placental Chorangioma by Microcoil Embolization

2018 ◽  
Vol 08 (04) ◽  
pp. e230-e233 ◽  
Author(s):  
Stephen Emery ◽  
Philip Orons ◽  
Jeffrey Bonadio
Keyword(s):  
Minimally Invasive ◽  
Clinical Outcomes ◽  
Vaginal Delivery ◽  
Laser Photocoagulation ◽  
Fetal Loss ◽  
Bipolar Coagulation ◽  
Successful Management ◽  
Healthy Neonate ◽  
Prenatal Management ◽  
Interstitial Laser

AbstractOptimal prenatal management of giant placental chorangioma (also known as chorioangioma, angiomyxoma, fibroangiomyxoma, or fibroma) has yet to be determined. Interventions intended to devascularize the tumor such as interstitial laser, bipolar coagulation, fetoscopic laser photocoagulation, and chemical embolization have met mixed results. We report a minimally invasive, extra-amniotic approach, technically similar to cordocentesis, of microcoil embolization of the feeding vessel. These percutaneously placed microcoils initiate clot formation at the site of insertion and are unable to migrate through the tumor, thereby minimizing fetal harm by downstream embolic phenomena. Intervention at 26 and 22 weeks resulted in intraoperative fetal loss in the former and vaginal delivery at term of a healthy neonate in the latter. Preoperative, intraoperative, and placental findings are highlighted. The ease and safety of this procedure may alter the risk–benefit equation toward earlier intervention with potentially better clinical outcomes.

Proposal for Bipolar Coagulation of the Sella Turcica Wall during Pituitary Tumor Operation

Neurosurgery ◽  
1987 ◽  
Vol 21 (4) ◽  
pp. 588-590 ◽  
Author(s):  
Walter J. Levy
Keyword(s):  
Sella Turcica ◽  
Front Surface ◽  
Coagulation System ◽  
Direct Visualization ◽  
Tumor Removal ◽  
Bipolar Coagulation ◽  
Recurrence Rates ◽  
Local Invasion ◽  
Flexible Wire ◽  
A Site

Abstract Convoluted morphology, limited visualization, and the lack of appropriate instruments limit the surgical approach to the walls of the sella turcica. They are, however, a site of local invasion and retained tumor fragments in cases of pituitary lesions. Effective bipolar coagulation within the sella turcica could reduce recurrence from local invasion, but it is made difficult because rigid bipolar forceps cannot fit effectively or safely against the complex contours of the walls there. Effective coagulation and thorough tumor removal are further frustrated by the lack of direct visualization of either the sella walls or the part of the floor adjacent to the surgical opening. It would be desirable, however, to coagulate the dura mater and retained tumor fragments. As an aid in this problem, we are reporting the use of a flexible bipolar coagulation system in two forms and of a mirror system for visualization in the sella without requiring the removal of one hand from surgical maneuvers. A pair of parallel flexible wire extensions to the standard bipolar forceps can be shaped by the surgeon into a contour that will coagulate the specific local terrain. A web of wire woven into one surface of a cotton patty, which is a bipolar coagulation system, supplements the wire loops. This allows the walls of the sella turcica to be coagulated more effectively where the contours are difficult to gauge and not well visualized. For visualization of the sella turcica walls and floor, we have used a small front surface mirror 1.0 mm thick. With a small suction-cotton patty placed behind the mirror, the mirrior can be used to dry fields or those with a mild ooze. It provides good visualization of the sellar walls when focused on by an operating microscope. In 11 cases, this system was an aid in control of bleeding and allowed coagulation of the sella walls. Furthermore, it has allowed identification of persistent tumor fragments on the sella wall in 3 cases. These fragments were then removed, and their attachment was coagulated. This capability may allow identification and coagulation of tumor that cannot be reached currently. If these sites are so treated, recurrence rates may be reduced significantly.

Combined minimally invasive surgical treatment of chronic internal hemorrhoids

2020 ◽  
pp. 76-83
Author(s):  
S. Egupov ◽  
G. Rodoman
Keyword(s):  
Minimally Invasive Surgery ◽  
Surgical Treatment ◽  
Surgical Technique ◽  
Minimally Invasive ◽  
Invasive Surgery ◽  
Long Term Results ◽  
Minimally Invasive Surgical ◽  
Surgical Methods ◽  
Internal Hemorrhoids ◽  
Minimally Invasive Surgical Treatment

This article is devoted to the results of applying the original minimally invasive surgical technique for the treatment of chronic internal hemorrhoids. The purpose of the study is to improve the outcomes of treatment in patients with chronic internal hemorrhoids by the simultaneous use of pathogenically substantiated low-traumatic surgical methods: dearterialization of internal hemorrhoids with Doppler guidance and clamping with latex rings. Materials and methods. Study included 204 patients with chronic hemorrhoids of the II–III degree, divided into 3 groups depending on the technique of minimally invasive surgery. The standard research methods for coloproctology were used. Results. It was found that the best short-term and long-term results of the surgical treatment of chronic internal hemorrhoids were obtained using the combined surgical technique proposed by the authors. Conclusions. The proposed combination of minimally invasive surgery may be the method of choice in the surgical treatment of chronic hemorrhoids of the II–III degree.

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