[Nd:YAG laser for anorectal surgery: initial experience in Israel]

The use of laser in gastrointestinal diseases started in the mid-70's. The 3 types of laser in use today are CO2, argon and Nd:YAG. We present the first clinical results in Israel of the use of the Nd:YAG laser in anorectal surgery. Between Oct. '91-Dec. '92, 275 patients with anorectal diseases (mostly hemorrhoids, anal fissures and fistulas) and 67 with various perineal lesions were operated on. Within an hour of the end of the operation, most patients were discharged to home with detailed follow-up instructions. 8 needed an extra day of observation in hospital. Postoperative complications included: bleeding (8 patients), wound infection (4) and urinary retention after hemorrhoidectomy (8). 1 patient complained of anal laxity after sphincterotomy, and 4 of recurrence of anal fissure. It is our impression that after laser hemorrhoidectomy patients return quickly to their normal lives; that the rate of complications is not greater than after other accepted techniques; and that the laser method for anal fistulectomy is most efficacious.