Background: The Hemorrhoid Laser Procedure (HeLP) is a good procedure to treat grade II and III hemorrhoids in patients
who have failed to respond to nonoperative measures. However, poor resolution of the mucosal prolapse especially with
higher degrees of hemorrhoids was noticed in many studies.
Objective: Evaluation of hemorrhoidal laser procedure combined with anal mucopexy (HeLPexx) and report its results
on second and third-degree hemorrohoids.
Patients and Methods: This prospective observational study was conducted on 35 patients with second or third-degree
piles. Patients were followed from day zero postoperative to 6 months regarding postoperative pain and other postoperative
complications such as bleeding, discharge, stenosis, and recurrence.
Results: Postoperative pain was detected by visual analog scale (VAS) score at baseline (day zero postoperative),
day 7, week 4, 3, and 6 month postoperative. On day zero the median score was 5, on day 7 the median score was 2, after
1 month the median score was 1, after 3 and 6 months the median score was zero with a significant decrease in pain score
in comparison to postoperative pain in excisional hemorrhoidectomy. Only 5 cases complained of recurrence. No cases
were detected with perianal fistula or anal stenosis.
Conclusion: This study concluded Hemorrhoid laser procedure with anal suture mucopexy (HeLPexx) is an effective and
safe procedure in the treatment of second and third-degree piles, as this technique had a significant decrease in duration
of surgery, postoperative bleeding, and pain with no stenosis or fecal incontinence.