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May 19, 1989

Colon and Rectal Surgery

JAMA. 1989;261(19):2833-2834. doi:10.1001/jama.1989.03420190109029

The rapid pace of technological advance requires monitoring and evaluation of the proposed application. Within colon and rectal surgery, at least seven new means to treat internal and external hemorrhoids or combinations thereof have been introduced recently. Indications for these newer treatments and an assessment of their utility were recently reviewed by Salvati.1 The vast majority of hemorrhoidal problems can be managed in an ambulatory setting. Laser technology, including neodymium:yttrium-aluminum-garnet (Nd:YAG), argon, and carbon dioxide, has been been reported to be of use in the treatment of primarily internal hemorrhoidal disease. Early efforts to treat internal hemorrhoids using air transmission Nd:YAG via endoscopes or handheld probes have progressed to coagulation, coaptation, and excision by contact Nd:YAG scalpel.2 Argon laser has been employed to treat internal hemorrhoids.3 The wavelength of argon is selectively absorbed by certain pigments, of which hemoglobin is one. Theoretically, hypervascular tissues such as hemorrhoids