• See Also
  1. Internal Hemorrhoid
  • Indications
  1. Indicated for Grades I to III Internal Hemorrhoid
    1. Most commonly used newer device
  2. Other uses
    1. Wart Treatment
    2. Tattoos removal
  • Advantages
  1. Quick and inexpensive
  2. No known Incidence of perineal Sepsis
  3. Less painful than Rubber band ligation
  • Disadvantages
  1. Less effective on Grade III Hemorrhoids
  2. Not effective on Grade IV Hemorrhoids
  3. Failure rate is 4 fold over that of Rubber band ligation
  • Initial Expense
  1. Device cost $2500
  • Mechanism
  1. Probe causes ulceration, scarring, tethering of mucosa
  2. Hemorrhoidal Vessels coagulated
  • Technique
  1. Insert Anoscope
    1. Identify most advanced Hemorrhoid complex
  2. Place tip of instrument at Hemorrhoid base (proximal)
    1. Apply 1.5 seconds per application
    2. Repeat for 4-5 applications per Hemorrhoid
    3. Apply several places along Hemorrhoid
  3. Recommend performing only one quadrant per visit
    1. Patient returns in 3-4 weeks for a second quadrant
  • Efficacy
  1. Rectal Bleeding relieved in 90%
  2. Symptom free
    1. At 3 months: 80%
    2. At 1-4 years post-treatment: 40%
  3. Prolapse twice as likely at 1 year as with banding