Punnawat Chandrachamnong¹, Thanat Tantinam²

Objective: Hemorrhoidal disease impacts quality of life. While hemorrhoidectomy is the standard for grades 3 and 4 internal hemorrhoids, its pain is a downside. The Rafaelo technique, using radiofrequency ablation (RFA), is a promising non-excisional alternative. The present study investigated postoperative outcomes of this innovative approach.

Materials and Methods: The authors conducted a single-center study performed by a single surgeon between January and December 2022. The surgical procedures were performed using a combination of intravenous sedation and perianal block.

Results: Forty patients underwent the Rafaelo technique, with a mean age of 49.7±15.1 years. Among them, 24 (60%) were male, and 16 (40%) were female. Thirteen patients (32.5%) had grade 2 hemorrhoids, while 27 patients (67.5%) had grade 3 hemorrhoids. The visual analog scale (VAS) scores were consistently low within the first 24 hours after surgery with VAS 1.1±1.4 at 4 hours, 1.18±1.54 at 8 hours, and 0.58±1.04 at 12 hours. Ninety-seven-point-five percent of the patients could be discharged on the first day, and eighty-five percent resumed their daily activities after discharge. Additionally, two cases developed thrombosed hemorrhoids as the postoperative complication, which were successfully treated conservatively. The symptoms severity score significantly decreased from 4.15±1.69 preoperatively to 1.03±1.37 at two weeks and 0.00 at three months. There were no cases of recurrence within the 6-month postoperative period.

Conclusion: The Rafaelo technique has demonstrated remarkable safety and effectiveness in treating grade 2 and 3 internal hemorrhoids. Notably, it minimizes postoperative pain and yields favorable outcomes at six months.

Received 1 July 2024 | Revised 16 November 2024 | Accepted 26 November 2024

DOI: 10.35755/jmedassocthai.2025.1.49-57-01338