BLEEDING
Bright red blood on paper, on the stool or in the toilet bowl.
חזרה לשירותיםDISCREET · FUNCTIONAL · INDIVIDUALISED CARE
מחלות פי הטבעת והרקטום ומחלה פילונידלית
Contemporary options for haemorrhoids, fissure, fistula, pilonidal disease, prolapse and early lesions, prioritising function.
RAFAELO® / LASER / THDSPHINCTER PRESERVATIONTEM / TAMIS
לצפייה בניתוחיםלתשומת לב: הניווט בעמוד זמין בעברית. התוכן הרפואי המפורט בעמוד המקצועי מוצג בשלב זה באנגלית.
ELIXIS · ADVANCED CARE
Same symptom, different disease — accurate diagnosis first
Bleeding, pain or swelling do not always mean haemorrhoids. Examination and selected functional or imaging tests come before treatment.
תסמינים
Symptoms that merit assessment
Haemorrhoids, fissure, abscess or fistula, pilonidal disease and rectal prolapse can cause similar complaints but require different treatment. Proper assessment is particularly important with bleeding or persistent pain.
PAIN
Sharp pain during a bowel movement or continuous throbbing pain.
LUMP OR PROLAPSE
A painful lump or tissue protruding from the anus.
ITCHING
Itching, irritation, moisture or difficulty keeping the area clean.
DISCHARGE
Mucus, pus or foul-smelling discharge may accompany inflammation or a fistula.
FUNCTIONAL CHANGE
Urgency, leakage or incomplete emptying merit functional assessment.
Bleeding should not automatically be attributed to haemorrhoids. Symptoms alone are not diagnostic and examination, endoscopy or imaging may be needed.
ניתוחים
Each condition and procedure, separately
From tissue-preserving to excisional procedures, selection depends on stage, anatomy and priorities.
01LASER
LASER HAEMORRHOIDOPLASTY
Targeted laser energy within haemorrhoidal tissue to promote shrinkage and fibrosis. Overall superiority to other techniques has not been established.
- מתי נשקל
- Selected internal haemorrhoidal disease without a major external component.
- מה כולל
- Small punctures and controlled intratissue application without wide excision.
02RAFAELO® · RFA
RAFAELO® RADIOFREQUENCY ABLATION
Controlled intratissue thermocoagulation of an internal haemorrhoid with a fine radiofrequency probe, aiming for shrinkage and fibrosis without anoderm excision.
- מתי נשקל
- Selected symptomatic internal haemorrhoids, mainly grade II–III, without a dominant large external component.
- מה כולל
- After local anaesthesia, the probe is placed centrally within the haemorrhoidal tissue above the dentate line and delivers controlled radiofrequency energy. Suitability is confirmed after proctological examination.
03THD · HAL-RAR
DOPPLER-GUIDED THD / HAL–RAR
Localisation and ligation of haemorrhoidal arteries, with mucopexy when prolapse is present. It usually causes less early pain but has higher recurrence than excisional haemorrhoidectomy in advanced disease.
- מתי נשקל
- Selected haemorrhoidal disease with bleeding and prolapse of internal haemorrhoidal tissue.
- מה כולל
- Doppler mapping, ligation sutures and mucosal lifting without anoderm excision.
04MM · ULTRASONIC
MILLIGAN–MORGAN WITH ULTRASONIC ENERGY
Excisional haemorrhoidectomy for advanced mixed disease using modern energy haemostasis.
- מתי נשקל
- Large external components, high-grade prolapse or disease unsuitable for a tissue-preserving technique.
- מה כולל
- Anatomical excision of diseased columns while preserving skin and mucosal bridges.
05FISSURE
ANAL FISSURE TREATMENT
Stepwise treatment of spasm and pain, prioritising continence preservation.
- מתי נשקל
- Chronic fissure persisting despite appropriate conservative care.
- מה כולל
- Topical therapy, Botox or carefully selected lateral sphincterotomy according to risk.
06FISTULA
ANAL FISTULA SURGERY
Mapping of the tract and treatment with the lowest possible sphincter risk.
- מתי נשקל
- A persistent tract after an abscess or an active complex fistula.
- מה כולל
- Drainage or seton, fistulotomy, LIFT or another sphincter-preserving option according to anatomy.
07SiLaC
PILONIDAL SINUS LASER · SiLaC
Intratract laser treatment of selected sinus tracts without wide skin excision. Long-term comparative evidence is limited and does not establish overall superiority.
- מתי נשקל
- Selected primary or limited disease without a large acute abscess.
- מה כולל
- Tract cleaning, fibre insertion and uniform controlled energy during withdrawal.
08RECTOPEXY
LAPAROSCOPIC RECTOPEXY
Anatomical suspension of the rectum for prolapse, tailored to function.
- מתי נשקל
- Full-thickness rectal prolapse. For selected internal prolapse, it is considered only after pelvic-floor testing and multidisciplinary review.
- מה כולל
- Mobilisation or ventral suspension selected according to constipation, continence and anatomy.
09TEM · TAMIS
LOCAL RECTAL EXCISION · TEM / TAMIS
Transanal removal of a selected lesion with magnification and precise margins, without abdominal resection. It does not provide lymph-node staging.
- מתי נשקל
- Selected large polyps and, as definitive treatment, only carefully selected low-risk cT1N0 tumours after complete staging.
- מה כולל
- Full-thickness local excision and closure when appropriate. Adverse final pathology may require subsequent radical resection.
הדמיה אנטומית מקורית וריאליסטית לצורכי לימוד — אינה צילום מטופל.
תכנון ובטיחות
Sphincter function is part of the treatment
The newest technique is not automatically the best. The goal is the right balance between disease control, pain, healing and function.
DIAGNOSIS
Accurate examination before treatment.
MAPPING
MRI, ultrasound or functional testing when required.
CONTINENCE
Baseline continence risk is assessed before sphincter surgery.
FOLLOW-UP
Follow-up of healing and functional outcome.
שאלות
שאלות נפוצות
תשובות קצרות לפני הערכה כירורגית אישית.
01How long does recovery take?
Recovery varies with the procedure, disease severity and general health. The individual plan covers mobilisation, diet, work and exercise.
02Is laser always better?
No. Overall superiority has not been established. It may reduce access trauma in well-selected cases, but suitability and recurrence risk depend on anatomy and disease stage.
03Is colonoscopy needed for bleeding?
It depends on age, symptoms, family history and warning signs. Bleeding should not automatically be attributed to haemorrhoids.
ראיות קליניות
ראיות קליניות
הבחירה הסופית מבוססת על התמונה הקלינית, האנטומיה וההנחיות העדכניות.
01ASCRS · Management of Hemorrhoids 2024Official guidance for excisional and non-excisional techniquesמקור רשמי02European Society of Coloproctology · GuidelinesEuropean colorectal guidanceמקור רשמי03ASCRS · HemorrhoidsSymptoms, diagnosis and treatment optionsמקור רשמי04ASCRS · Abscess and FistulaWarning signs of abscess and fistulaמקור רשמי
המידע מיועד להסברה ואינו מחליף בדיקה רפואית. יתרונות, סיכונים וחלופות נידונים באופן אישי.
הערכה כירורגית אישית
הניתוח הנכון מתחיל בהתווייה הנכונה.
בפגישה נבחנים התסמינים, הבדיקות והחלופות.
מרפאת REA MED והגעה