The Clinic at Beverly Hills

ELITE – Laser Hemorrhoidoplasty

What are
hemorrhoids?

Hemorrhoids are a natural part of the human body and, when healthy, assist with the closure of the anus.
Hemorrhoids are vascular cushions that move blood to and from the anus and help support the function of the sphincter. Most people think of hemorrhoids as the disorder known as hemorrhoids or piles.
Hemorrhoids as a disorder are swollen veins or blood vessels in and around your lower rectum and anus, similar to varicose veins. These swollen vessels cause irregular protrusions, which can cause pain and bleeding. They are very common for both males and females and will occur in approximately half of the population by age 50.

Hemorrhoids can be both internal and external.
Internal hemorrhoids either do not protrude out of the anus or return inside either on their own or by manual manipulation. They are often painless but tend to cause bleeding.
External hemorrhoids are located outside of the anus and can often feel like small lumps. They tend to cause discomfort, itching and difficulty sitting.

Symptoms of Hemorrhoids

Pain during bowel movements
Blood in stool or toilet bowl
Itching and/or irritation around the anus
Pain while sitting
Tissue swelling around the anus
Anal discharge

What are the risk factors for hemorrhoids?

Obesity
Pregnancy
Lifting heavy
Straining on the toilet
Family history of hemorrhoids
Long-term or chronic constipation or diarrhea

What are hemorrhoids?

The ELITE Hemorrhoid Treatment (Laser Hemorrhoidoplasty) is an innovative treatment option that is minimally invasive option that uses laser to treat hemorrhoids. During this procedure, a laser probe is inserted into the targeted hemorrhoid and activated. In its active state, the laser causes the arterial flow to coagulate, resulting in shrinkage of the hemorrhoid over the next several days.

ELITE does not require any incisions or sutures, which reduces the risk of infection, incontinence and pain significantly.

Advantages:
Very effective
Minimal to no pain
Quick return
to normal activities
Minimally invasive
Low risk of infection
No incision or sutures required
Low to no chance
of incontinence
Can be used on all grades
of hemorrhoids

Grades of Hemorrhoids

01

Grade 1

Internal hemorrhoids that protrude into the anal canal but do not prolapse outside the anus.
02

Grade 2

Internal hemorrhoids that can protrude outside the anus during straining but spontaneously return to their original internal position after straining has subsided.
03

Grade 3

Internal hemorrhoids that can protrude outside the anus during straining or exertion and need manual replacement into the anal canal.
04

Grade 4

Prolapsed hemorrhoids which will not go back inside the anus and cause severe discomfort.

Alternative Treatments

Rubber Band Ligation

A surgeon uses a rubber band, placing it around the base of the hemorrhoid, causing the blood supply to be cut off. With no blood supply, the hemorrhoid will shrink and fall off over the next few days.

Advantages:

– Painless
– In-office procedure
– Covered by provincial insurance

Disadvantages:

– Should not be used on patients on blood thinners
– May cause excessive bleeding
– Can require multiple treatments, depending on
the number of enlarged hemorrhoids
– Low Success Rate

Sclerotherapy

A chemical solution is injected into the area around the hemorrhoid, causing damage to the blood vessels feeding the
hemorrhoid, which causes it to shrink.

Advantages:

– Minimal to no pain
– In-office procedure
– Quick return to everyday activities
– Can be used for individuals on blood thinners
– Covered by provincial insurance

Disadvantages:

– 4-6 weeks for hemorrhoid to shrink
– Some may experience an allergic reaction to
the chemical
– Only recommended for grade 1 and 2 hemorrhoids

Excisional hemorrhoidectomy

During a traditional hemorrhoidectomy, excess tissue is removed using a scalpel, requiring sutures to close the wound. A hemorrhoidectomy is an effective treatment but can have serious side effects, including infection and incontinence.

Advantages:

– Very effective
– Covered by provincial insurance
– Can be used for both 3rd and 4th grade hemorrhoids
– Covered by provincial health insurance

Disadvantages:

– Painful
– Long recovery time
– Risk of infection
– Risk of incontinence
– Performed under anesthesia
– Risk of permanent damage to the anal canal
– Hospital stay required

Hemorrhoidopexy or stapled hemorrhoidectomy

Hemorrhoideopexy requires no incisions, and instead, staples are used to remove excess tissue and to place the prolapsed hemorrhoids back in place.

Advantages:

– Very effective
– Lower risk of infection

Disadvantages:

– Can cause a constant urge to defecate
– Can cause damage to the wall of the rectum
and vaginal wall
– Cannot treat grade 4 hemorrhoids

Transanal Dearterialization of Hemorrhoids (THD)

TDH is a minimally invasive technique that uses a doppler ultrasound to identify the arteries that supply the hemorrhoid. Sutures are then used to limit the blood flow and place the prolapsed hemorrhoids back in place. The reduction in blood flow causes shrinkage of the hemorrhoid.

Advantages:

– Performed in clinic
– Lower risk of infection
– Highly effective

Disadvantages:

– Not covered by provincial insurance
– Some risk of infection

Hemorrhoid Consult

Name(Required)
Please Note: A member of our team will contact you shortly to book and confirm your consultation. No referral is required for a hemorrhoid consultation.

Dr. Ravi Kumar completed his Bachelor of Health Sciences at McMaster University. He then pursued his Medical Doctorate and Urology residency at The University of Ottawa. He subsequently completed a fellowship in Urologic Oncology and Robotic Surgery at the Princess Margaret Cancer Centre at the University of Toronto. During his fellowship, he obtained a Master of Engineering from the Institute of Biomedical Engineering at the University of Toronto. He is the co-lead author of the Canadian Urological Association/American Urological Association guideline on the diagnosis and management of adrenal masses.

Dr. Kumar treats a wide variety of urologic conditions including BPH and kidney stones, with a special focus on delivering cutting-edge care for prostate cancer, kidney cancer and bladder cancer.

Dr. Ashwin Maharaj obtained his undergraduate degree in Biology/Physiology from the University of Western Ontario (BSc). e became certified through is a Diplomate of the American Board of Surgery and was certified as fellow of the American College of Surgeons (FACS) and recently recertified. He is a member of the Canadian Association of General Surgeons. His current clinical interests are devoted to outpatient acute and chronic gastrointestinal medicine/surgery as well as abdominal wall hernia surgery and practices in certified facilities in Toronto. He has research experience in gastrointestinal disease as well as surgical education teaching resident surgeons and medical students.

Dr. Diana Magee completed her undergraduate education at Cornell University followed by a Master of Public Health degree at Boston University. She received her medical degree from Queen’s University and completed her urology residency at the University of Toronto. While in residency she enrolled in the Surgeon Scientist program and completed her Master of Science in Health Services Research. She completed her fellowship in urologic oncology at Fox Chase Cancer Center in Philadelphia. Dr. Magee’s area of expertise is in the management of urologic cancers as well as performing minimally invasive surgery.

Dr. Pianezza completed his medical degree (MD) at the University of Ottawa in 2002. He became a member of the Royal College of Physicians of Canada (FRCSC). He then completed a one-year fellowship in minimally invasive surgery and endourology at the University of Alberta in Edmonton in 2008.

Dr. M. Pianezza has been a staff urologist in Sudbury at the Health Sciences North since January 2010. He was Head of Urology from February 2013 to September 2016. He is an Assistant Professor of Surgery at the Northern Ontario School of Medicine.

Dr. Heimrath completed his medical school at the University of Ottawa, his surgical residency at McGill University, and his Endourology, Minimally Invasive, and Robotics Fellowship at the University of Toronto. Dr. Heimrath’s areas of expertise include the management of complex kidney stones and urologic cancers as well as performing minimally invasive surgery. Since 2016, Dr. Heimrath has worked overseas in Malawi and Rwanda to explore opportunities to build urologic and surgical capacity in the developing world. He is a partner in the Urology Global Surgery initiative at the University of Toronto and holds a lecturer appointment with the University of Toronto.

Endoscopy

Procedures & Conditions Treated

SIBO for IBS

Small intestinal bacterial overgrowth (SIBO) is a clinical condition characterized by a malabsorption syndrome due to an increase in microorganisms within the small intestine.

Gastric ballon

The Clinic at Beverly Hills offers patients the option between two industry leading gastric balloon procedures. The traditional endoscopy guided Orbera Gastric Balloon and the revolutionary swallowable Allurion Gastric Balloon.

Laser Hemorrhoid Treatment

Hemorrhoids are a natural part of the human body and, when healthy, assist with the closure of the anus.

Hemorrhoids are vascular cushions that move blood to and from the anus and help support the function of the sphincter. Most people think of hemorrhoids as the disorder known as hemorrhoids or piles.

Stress Urinary Incontinence

Stress Urinary incontinence (SUI) means the uncontrollable loss of urine – an involuntary loss or leakage of urine during precipitating activities like coughing, laughing, sneezing, straining, exercising etc. Early signs of SUI are complaints relating to dysuria, frequency, and urgency. At TCBH Surgical Centre, we offer two treatment options for Stress Urinary Incontinence.

iTind

Benign prostatic hyperplasia (BPH) is a condition in which your prostate grows in size. Your prostate is a gland that rests below your bladder and in front of your rectum. It’s about the size of a walnut, and it surrounds part of your urethra. Your urethra is a tube that carries urine and sperm (ejaculate) out of your body. If your prostate grows in size, it can prevent urine and ejaculation from passing through your urethra. BPH is not cancerous. However, symptoms of BPH may indicate more serious conditions, including prostate cancer. TCBH Surgical Centre provides two treatment options.

Rezum Water Therapy

How The Rezum™ Water Vapor Therapy Works

  • RezumTM Water Vapor Therapy is a novel technology that helps people who are suffering from BPH symptoms.
  • In each application, sterile water vapor is released to the targeted prostate tissue. When the steam turns back into the water, all the stored energy is released, causing the cells to die.
  • Over time, your body’s natural healing response removes the dead cells, shrinking the prostate. With the extra tissue removed, the urethra opens, reducing BPH symptoms.
  • The maximum benefit may occur within three months.
    Patients’ responses to treatment can and do vary.

Nanoknife for Prostate Cancer

NanoKnife or Irreversible Electroporation (IRE) consists of placing a number of electrodes into the prostate to surround the area of significant cancer.

Short pulses of electricity using very high voltage are passed between the electrodes. This causes micropores to occur in all cells, including the cancer cells, which lead to their death.

Dr. Luke Fazio is the current Chief of Urology at Humber River Hospital. Dr. Fazio received his medical degree from McGill University in 1999. Following this, he finished his Endourology and Minimally Invasive fellowship at the University of Toronto. As the Urology Medical Director, he has brought many minimally invasive programs to TCBH and is working on future projects. He currently sits on numerous committees and is an advocate for innovation in healthcare. He is the physician lead for the Da Vinci Robotic Surgery Program. He also is the Chair of the Innovation Committee.

Dr. Bhargava has a primary focus of providing care for her patients in the form of minimally invasive procedures and cutting edge technology. She is the Medical Director of TCBH Surgical Centre (The Clinic at Beverly Hills Healthcare) and has been instrumental in bringing Laser Hemorrhoid Treatment to her Centre.

Achievements:
Dr. Bhargava completed both her medical school and surgical residency at the University of Western Ontario. In addition to her Bariatric fellowship, she has also completed Minimally Invasive fellowship at the University of Cincinnati in Ohio.
Dr. Bhargava has published multiple research papers and lead articles.

Memberships:
Canadian Medical Association, Canadian Association of General Surgeons, Society of American Gastrointestinal and Endoscopic Surgeons, Royal College of Physicians and Surgeons of Canada, College of Physicians and Surgeons of Ontario, and American Society of Bariatric Surgery