A Proctologist‘s Guide: How to Select the Optimal Hemorrhoid Fiber
Introduction: From Decision to Specification—The Final Mile
You’ve understood the clinical benefits and made the informed choice to adopt laser therapy, likely favoring the <>uniform efficacy of radial fiber technology. Now comes the critical, yet often overlooked, final step: translating that clinical decision into the correct physical device. Selecting the wrong specifications can nullify the very advantages you seek. This guide is your definitive checklist to navigate the technical landscape, ensuring the fiber you procure delivers optimal performance, safety, and value for your practice.
The Non-Negotiable Foundation: Laser System Compatibility
This is the first and most critical filter. An incompatible fiber is unusable.
1.1. Laser Wavelength (nm): This is an absolute match. Common surgical laser wavelengths are 1470 nm, 980 nm, and 1064 nm. Your fiber must be explicitly rated for your laser’s exact wavelength. Using the wrong wavelength will result in catastrophic energy loss or damage.
1.2. Connector Type: The fiber must physically and optically connect to your laser. Common types include SMA 905, D80, or proprietary connectors. Mismatch means no connection.
Action Item: Locate your laser’s user manual. Write down the exact output wavelength and connector type/model. This is your buying bible.
Anatomical Match: Selecting Fiber Diameter & Length
With compatibility confirmed, now match the fiber to your patient anatomy and procedural style.
Fiber Diameter (µ): The “Size of the Tool”
The diameter must suit the target hemorrhoidal tissue for effective energy transfer and safe maneuverability.
Standard Range: Hemorrhoid fibers typically range from 400µm (0.4mm) to 1000µm (1.0mm).
Selection Logic:
Thinner Fibers (400-600µm): Offer greater flexibility, ideal for navigating the anal canal and treating smaller, more tortuous bundles (Grade I-II). They allow for more precise placement with less tissue displacement.
Thicker Fibers (800-1000µm): Provide greater rigidity (“pushability”), which can be advantageous for straightforward insertion into larger, firmer bundles (Grade II-III). They may also offer slightly higher mechanical durability.
Practical Advice: For a versatile starting point, a 600µm radial fiber often serves as an excellent “workhorse” for a wide range of cases.
Working Length (cm): The “Reach of the Tool”
This determines how far from your laser you can operate.
Standard Lengths: 100cm to 200cm are common.
Selection Logic: Consider the distance from your laser console to the patient, plus enough slack for comfortable manipulation. A 150cm length is standard for most outpatient procedure room setups. Longer lengths (200cm) offer maximum flexibility for larger rooms or unusual layouts.
Quality & Safety Specifications: Decoding the Data Sheet
Look beyond diameter and length. These specs separate premium from generic products.
| Specification | What to Look For | Why It Matters |
| Transmission Efficiency | > 85% (Higher is better). | The percentage of laser energy that actually exits the fiber tip. Low efficiency means wasted energy, poor clinical effect, and potential overheating at the connector. |
| Sterilization Method | Validated Ethylene Oxide (EtO) process. Package must be individually sealed and labeled. | Guarantees sterility. Re-sterilized or non-sterile fibers are unacceptable for single-use in surgery and pose infection risks. |
| Minimum Bend Radius | A clearly stated, conservative value (e.g., 2-3 cm). | Bending the fiber tighter than this can cause internal fractures, leading to energy loss at the break point and potential device failure mid-procedure. |
| CE / FDA Mark | Appropriate regulatory clearance for your region. | Indicates the device meets essential safety and performance standards. |