Novel Technique: Radiofrequency Coagulation -- A Treatment Alternative for Early-Stage Hemorrhoids

Pravin J. Gupta, MS [Gen. Surgery]

In This Article

The Radiosurgical Unit

There are a number of radiosurgical units on the market; we used the Ellman Dual Frequency unit byEllman International, Hewlett, New York. The unit comprises a transformer that converts the main voltage of 220 AC to high voltage and high-frequency energy; its filtering and rectification waves produce 4 different waveforms. The fully filtered and rectified current is used for cutting. The fully rectified current is used for simultaneous cutting and coagulation. The partially rectified current is used for coagulation, and the fulgurating current is used for destruction of large masses.

We have found the partially rectified mode to be best suited for coagulation.[5] The ball electrode with a length of 11 cm, which is supplied with the unit, proved useful and was extensively employed for this procedure.

Internal hemorrhoids are normal vascular cushions containing an arteriovenous network. Therefore, a therapy based on reducing downward anal pressure and fixation of the anal cushions to muscular fibers should be the ideal choice.[6] Indeed, in this study, we found that fixation of the anal cushions to the muscular fibers could be effectively accomplished with the radiofrequency procedure.[5]