METHOD OF TREATING OF CHRONIC INTERNAL HAEMORRHOIDS OF STAGES 2-4 Russian patent published in 2024 - IPC A61N5/67 A61B18/20 A61B17/00 

FIELD: medicine; surgery.

SUBSTANCE: laser haemorrhoidoplasty is performed, followed by Doppler-controlled disarterization of haemorrhoids. When performing laser haemorrhoidoplasty, at a distance of 1 cm from the anoperineal junction, in the projection of the largest of the haemorrhoids, a 0.3 cm long perianal skin incision is made. A fibre optic probe with a cone-shaped tip is inserted through the tissue of the haemorrhoid parallel to the wall of the anal canal, and it is passed to the level of the projection vascular pedicle of the haemorrhoid. Using laser radiation with a wavelength of 1,470 nm and a power of 8 W, hemorrhoidal tissue located in the direction of the fibre optic probe is heated for three seconds. Then the probe is pulled up by 0.5 cm and shifted distally by 0.5 cm relative to the axis of the haemorrhoid, applying laser radiation, after which the fibre-optic probe is shifted in the opposite direction and the exposure is repeated. Then the probe is pulled up again by 0.5 cm and a similar effect is performed at three points located at a distance of 0.5 cm from each other, after which the fibre optic probe is removed from the wound. After this, Doppler-controlled disarterization of haemorrhoids is performed, for which, through a proctoscope with a hole in the side wall, under ultrasound Doppler navigation, the vascular pedicle of the haemorrhoid is sutured at 1 o’clock on the conventional dial with the formation of an 8-shaped suture with tying 5 simple knots, after which, by cutting the thread, sequential stitching of the rectal mucosa is performed in three rows. After forming three rows of stitches, the ends of the thread are tied with tension so that the stitched tissues are “gathered” in the form of a zone with a diameter of not more than 1 cm. Similar manipulations are performed on all the remaining haemorrhoids.

EFFECT: reduction of the risk of thread cutting in the postoperative period and reduction of the frequency of bleeding in the postoperative period, reduction of the risk of disease relapse.

1 cl, 7 dwg, 3 ex