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Foire aux questions
Which are the indications of the Angiodin LDL2 procedure?
Stage II, III degree, (with the only exception of an external fibrosis)
Does ligature of all of the terminal branches can create a necrosis?
No, because you only ligate the branches of the superior rectal artery, which contributes exclusively to the functional blood supply of the cushions while the mean and inferior rectal arteries are left intact.
Are cases of sepsis or rectal abscesses reported?
No, with thousand of patients treated with this technique worldwide, not a single case of sepsis or abscesses have been reported.
Are those cases of tenesmus described, the result of a technical problem, while performing the procedure?
No, tenesmus is a minor symptom which disappears after the few first days, logically due to the mucosal pexis in the anal canal. The starining envy is due to the filling of the rectal apula (you should advise the patient ”not” to strain.
Are cases of stenosis been reported?
No, however do make sure not to create a restriction of the anal canal by stitching together distant parts of it. (the stitches should be well separated, at a digital examination).
When in doubt of having applied a stitch too superficial or too close to the dental line, what can be done?
One of the advantages of this procedure is that, at any time, it can be undone. Repeat the stitch.
Can this technique be performed in“redo”cases of therelapses of othertechniques?
Yes, with no adverse expected results.
Can this technique be performed in cases of acute thrombosed piles or anal fistulas?
No, it I recommended to wait sometime after having treated the acute symptoms.
Can this technique be performed in cases of anal fissures?
Yes, it may even be recommended on those patients where the sphincter hypertone associated with fissures results in symptomatic haemorrohoids.
Is general or spinal anesthesia required for performing the procedure ?
Yes it is recomanded due to the size of the proctoscope (34mm).
What type of analgesic drugs are recommended in the post-op?
In our experience, over 50% of the patients do no require any analgesia. If needed, recommend oral analgesics.
The tissue lifted by the continuous suture pexis does not slide down again once the sutures are absorbed?
No because a fibrosis forms in the first 4 weeks, which holds the tissue together, fixated to the anchorage in the sub mucosa.
What is reported relapse rate?
Both on bleeding and prolapse, less than 7%.
And in advanced VI degree cases?
Could be done but requires a certain experience and results shall be confirmed but further studies.
Which are the complication reported?
Very minors: Anal fissures (2%); Thrombosed Piles (2%); Bleeding-usually spontaneously resolved (2%); Sub-mucosal haematoma (2%).