Introducing the brand-new Rafaelo Procedure for piles at Spire St Anthony’s Hospital with Mr Nick West, Consultant General and Colorectal Surgeon.
After three years of development and having successfully treated over 2,000 patients being treated across Europe with outstanding results, we are able to offer you the Rafaelo Procedure. Using the safe and established technology of radiofrequency ablation, the Rafaelo Procedure can be performed on a walk-in, walk-out basis, does not require a general anaesthetic and the patient is able to return to their normal daily activities immediately after treatment. The Rafaelo Procedure is ideally designed to treat haemorrhoid grades 1–3. Some grade 4 haemorrhoids may be reduced but likely not to a complete resolution, which often will require surgery.
Haemorrhoids (or piles as they are commonly known) are generally an unspoken curse from which many of us suffer but are too embarrassed to discuss with our loved ones, let alone our GP. They are enlarged vascular ‘cushions’ found just inside or around the bottom (anus and lower rectum), thought to be caused by a variety of factors but commonly constipation, diarrhoea or excessive straining. They are common and it has been estimated that up to 50% of the population may suffer from symptomatic haemorrhoids at some point in their lives*.
The result may be a significant period of discomfort, itching and/or bleeding which we try to subtly cure with lotions and potions bought from the chemist – these might well settle the problem or may just temporise the symptoms for a while. If symptoms recur it may be advantageous to seek a medical opinion at an earlier stage to obviate the potential for more significant treatments further in time. Those of us who have suffered in the past, and who have undergone medical intervention, may recall an unpleasant experience – whether successful or not, often one which we would rather was not repeated.
Haemorrhoids are graded from 1 to 4. The small early ones might not have any symptoms or may cause itching or spots of blood when opening one’s bowels, to the larger and more external grade 4 external haemorrhoids for which surgery is the only option.
Grade 1–2 haemorrhoids can remain untreated, be monitored, and then perhaps be ‘banded’, were the symptoms to persist. Banding is a commonly used treatment to the early-grade haemorrhoids (grade 1 or 2) which entails the suction of the pile or the area just above it using a special implement and then attaching a small elastic band around the base. This effectively strangulates the pile, reducing its blood supply. It will subsequently fall away after a week or so, often unnoticed. The application of the bands, however, can be very painful, as can the strangulation process which follows. The bands may snap or fall off prematurely, which will require a further application but, more importantly, significant bleeding could result. Even if a banding application is initially successful, recurrence rates are high and one can expect to have a further application at some point in the future. If left to grow over time without seeking medical help, or failing to address dietary, toilet or lifestyle habits (which could improve the condition in the early stages), they may develop into more advanced grades.
From then on, if banding is no longer deemed suitable, more formal surgical procedures may be required for treatment. This may involve removing the haemorrhoidal tissue by surgical excision, which is a very painful procedure, for a few weeks until the wound/s have eventually healed. Most often this would require time off work, which may be up to 2–4 weeks. This brings us back to why some people avoid seeking treatment in the first place– they simply don’t want to go through the pain of the treatment, and it may not be convenient to take time off work. It can be a vicious circle! Remember, all grade 4 haemorrhoids were grade 1 at one point. What is ideally needed is a treatment that is safe and reliable with good long-term results, but which is minimally invasive, only takes a few minutes to perform, is less painful than some other existing options and doesn’t require time off work.
*(Hemorrhoids: diagnosis and management. Am Surg 75 (8): 635–42)