2008 Volume 29 Issue 2 Pages 112-118
Hemorrhoidectomy based on the Milligan-Morgan technique, which has been conventionally used, is currently adopted as a standard radical procedure for internal hemorrhoids by Japanese clinical surgeons. However, problems related to the control of perioperative bleeding and the remission of postoperative complaints for a local site still remain. When a Nd-YAG laser contact probe is used instead of a scalpel or electrocautery, which are conventionally used in this operation method, hemorrhoids can easily be removed from the base layer with minimum invasion and without bleeding. The operation becomes easy using the Nd-YAG laser contact probe. Furthermore, the desired clinical outcomes, such as mild local algia and enlargement, rapid postoperative healing of operation sites, and shortening of hospitalization duration, can be achieved. To determine the effectiveness of the Nd-YAG laser contact probe, the outcomes of operation using this probe were compared with those using a scalpel or electrocautery through an animal experiment. At the site of laser probe surgery, the proliferation of keratinocytes was enhanced. Moreover, the expression levels of inducible nitric oxide synthase (iNOS), keratinocyte growth factor (KGF), and KGF receptor (KGFR) were higher with the use of the laser probe than with the use of a scalpel or electrocautery. On the basis of these findings, we concluded that reepithelization occurs at a relatively early stage after operation when using the laser probe. The Nd-YAG laser contact probe facilitates easy and bloodless operation, and rapid healing of the operation site; it is clinically effective for minimally invasive surgery.
