Method of Treating Hemorrhoids

Abstract

The invention relates to a method for the treatment of haemorrhoids and the use of said method for embolization and/or ablation of the underlying vein(s) that cause(s) haemorrhoids.

Claims

1. A method for treating and/or preventing haemorrhoids comprising: embolizing and/or ablating at least one pelvic vein and/or at least one of its tributaries.

2. The method according to claim 1, wherein said vein is an internal iliac vein or a tributary thereof.

3. The method according to claim 1, wherein said embolizing occludes, or blocks, said vein.

4. The method according to claim 1, wherein said embolizing and/or ablating involves the use of one of the following: laser or radiofrequency ablation; coil embolization; sclerotherapy; glue; clarivein MOCA; Endovenous Laser Ablation (EVLA); VNUS Closure FAST or Venefit; RFiTT; EVRF; steam vein sclerosis; and endovenous microwave ablation or any other device or substance used for embolizing, ablating or occluding blood vessels.

5. The method according to claim 1, wherein said method further involves treatment or removal of the haemorrhoids.

6. The method according to claim 5, wherein said treatment or removal of the haemorrhoids involves sclerotherapy of the haemorrhoid.

7. The method according to claim 6, wherein said treatment or removal of the haemorrhoids is performed at the same time as said embolizing of said vein.

8. The method according to claim 5, wherein said treatment or removal of the haemorrhoids is undertaken using any one or more methods selected from the group comprising: injection sclerotherapy; banding of the haemorrhoid; infra-red coagulation; radiofrequency ablation; cryotherapy; laser ablation of Haemorrhoidal artery; ultrasound ablation; haemorrhoidectomy; plication; Haemorrhoidal Artery ligation operation; and stapled haemorrhoidectomy.

9. The method according to claim 8, wherein injection sclerotherapy is undertaken using oily phenol or foam sclerotherapy.

10. The method according to claim 8, wherein Haemorrhoidal Artery ligation is undertaken using (HALO) Doppler Guided Haemorrhoidal Artery ligation.

11. The method according to claim 1, wherein trans-jugular coil embolization of said pelvic vein is performed.

Description

DETAILED DESCRIPTION

The Hembolize Procedure

[0064] The Hembolize procedure is an embolization of the underlying venous reflux in the internal iliac veins and/or tributaries of the internal iliac veins, stopping reflux into the haemorrhoids.

[0065] Access to the target veins is via the venous system from a remote locationthis can be, but is not restricted to, access via the internal jugular vein, the brachial vein or the femoral vein. The technique for accessing the vein involves passing a device into the vein, guiding it to a position under image control (typically usually x-ray although not restricted to this imaging technique) and then passing embolic material into the vein. Our hembolize procedure currently uses a combination of foam sclerotherapy and metal coil embolization but other embolic material or techniques for venous destruction, such as ablation, may be used.

[0066] However, what is new in this technique is that it targets the reflux in the internal iliac vein and/or its tributaries, thus preventing reflux into the haemorrhoids and therefore cutting off the source of the venous reflux that is filling the haemorrhoids.

[0067] Therefore in stark contrast to all the other available methods currently used for the treatment of haemorrhoids:

[0068] This approach is internal rather than externalthe approach being through the venous system and into the target vein where, from within, the underlying cause can be treated rather than attacking the haemorrhoid externally without addressing the underlying cause.

[0069] If there is no treatment to the haemorrhoid itself and no procedure performed across the anal canal, there is either no or minimal post-operative pain.

[0070] There is no cut nor healing tissue anywhere in the anal canal and therefore the passing of faeces causes no discomfort in the post-operative period.

[0071] The procedure is performed under local anaesthetic and therefore is a walk-in walkout procedure with no requirement for any hospital stay, general anaesthesia or regional anaesthesia.

[0072] There is no need for any post-operative pain killers.

[0073] As the underlying cause of the haemorrhoids has been treated there will be a lower recurrence rate.

[0074] There is minimal embarrassment to the patient as the operation is performed through the chosen access point, for example, the neck (via the internal jugular vein).

First Case:

[0075] The first case of Hembolize was performed at the Whiteley clinic in London on 28 Mar. 2015. The patient was male. He had previously had operative haemorrhoidectomy, injections and most recently a new technique using a probe, from externally, through the haemorrhoid to try and ablate the vein at the neck of the haemorrhoid. Unfortunately this had caused damage to the prostate and blood in the semen.

[0076] He had large haemorrhoids which were bleeding and uncomfortable. He consented to Hembolize as the alternative was a further haemorrhoidectomy.

[0077] This was performed via a right internal jugular approach and x-ray control on 28 Mar. 2015. It was performed under local anaesthetic as a walk-in walkout procedure. No post-operative pain killers were given or taken.

[0078] Since that time, his bleeding at passing stool has gone from every time to very rarely. His haemorrhoids have been shrinking weekly since the procedure, and the discomfort has been improving. He has been offered adjuvant injections but has refused them as the haemorrhoids are continuing to wither away following Hembolize.

Second Patient:

[0079] A male patient with haemorrhoids that were bleeding, protruding and causing severe discomfort underwent Hembolize on the eighth of August 2015 at the Whiteley clinic in Bond Street London.

[0080] Once again this was performed as a walk-in walkout procedure under local anaesthetic via a right internal jugular approach and under x-ray control. The patient reported on 11 August that his three major symptoms had completely resolved and he was delighted. He had had no further bleeding when passing stools, the haemorrhoids are starting to shrink and the discomfort had disappeared.

REFERENCES

[0081] 1Lorenzo-Rivero S. Hemorrhoids: diagnosis and current management. Am Surg. 2009 August;75 (8):635-42. [0082] 2Lohsiriwat V. Hemorrhoids: From basic pathophysiology to clinical management. World J Gastroenterol 2012 May 7; 18 (17): 2009-2017 [0083] 3Holdstock J M, Dos Santos S J, Harrison C C, Price B A, Whiteley M S.

[0084] Haemorrhoids are associated with internal iliac vein reflux in up to one-third of women presenting with varicose veins associated with pelvic vein reflux. Phlebology. 2015 March;30 (2):133-9 [0085] 4Ratnam L A, Marsh P, Holdstock J M, Harrison C S, Hussain F F, Whiteley M S, Lopez A. Pelvic vein embolisation in the management of varicose veins. Cardiovasc Intervent Radiol. 2008 November-December; 31 (6):1159-64. [0086] 5Dos Santos S J, Holdstock J M, Harrison C C, Whiteley M S. Long-term results of transjugular coil embolisation for pelvic vein refluxResults of the abolition of venous reflux at 6-8 years. Phlebology 2015In Press.