The Laser Revolution in Modern Hemorrhoid Treatment

Hemorrhoidal disease is a common proctological condition characterized by enlargement, prolapse, inflammation and bleeding of the vascular cushions located within the anal canal. Patients often present with bleeding during defecation, anal itching, mucus secretion, a sense of fullness, discomfort, prolapse and increased hygiene needs. In modern proctology, minimally invasive approaches in hemorrhoid management have gained considerable interest. Among these approaches, laser hemorrhoid treatment has become increasingly preferred due to its tissue-preserving nature, low pain levels and rapid recovery.

The fundamental principle of laser hemorrhoid treatment is to deliver a specific level of laser energy into the hemorrhoidal vascular cushion to induce thermal coagulation and controlled volume reduction. This decreases hemorrhoidal volume, reduces bleeding tendencies and improves patient quality of life. Preservation of the continence mechanism is a major advantage compared with conventional hemorrhoidectomy, as no dissection or interruption of anal anatomy is required.

Laser therapy yields favorable results particularly in mid-stage internal hemorrhoids, namely Grade II–III. Proper indication selection is essential in patients presenting with bleeding, mucus secretion, fullness and occasional prolapse. In Grade IV disease, laser may not be sufficient as a stand-alone option; hemorrhoidectomy, THD or combined approaches may be considered. Nevertheless, laser can serve as a supportive method in selected patients.

The procedure may be performed as outpatient surgery. The laser probe is directed into the hemorrhoidal tissue and energy is delivered; the procedure is completed in approximately 15–25 minutes. Most patients are discharged the same day and return to daily activities. Low postoperative pain increases treatment compliance and patient satisfaction, especially among individuals who avoid conventional surgical methods.

Recovery is rapid. Mild pain, fullness or minimal bleeding may occur for several days following the procedure. Functional recovery is generally achieved within 2–3 weeks. Compared with hemorrhoidectomy, which requires incision and suturing, the postoperative period is significantly more comfortable.

Clinical outcomes may vary depending on hemorrhoid stage, bowel habits, chronic constipation or diarrhea, pelvic floor function, transit time and coexisting anorectal disorders. Chronic constipation is a significant factor contributing to recurrence. Therefore, treatment should include lifestyle modification, adequate hydration, dietary fiber and toilet training when necessary.

When compared with alternative methods, several advantages become apparent. Hemorrhoidectomy is a strong and radical option but characterized by prolonged recovery and higher pain. THD relies on arterial ligation and mucopexy and is beneficial in patients with bleeding and prolapse. Rubber band ligation produces favorable outcomes in Grade II disease and can be performed in outpatient settings; however laser may be superior in terms of postoperative comfort. Laser Hemorrhoidoplasty (LHP) described in the literature represents a minimal-invasive strategy that preserves continence.

Complication rates are low; transient pain or edema may occasionally occur. Recurrence is typically observed in advanced-stage disease or in patients who do not incorporate lifestyle adjustments or who present with defecatory dysfunction.

Interest in laser hemorrhoid treatment has increased markedly in Ankara in recent years. Most patients return to their routines within a short period and productivity loss is minimized. Appropriate indication, experienced surgeons and comprehensive management significantly improve clinical outcomes.

In conclusion, laser hemorrhoid treatment has become an important option in modern hemorrhoid management with its minimal invasiveness, low pain, rapid recovery and tissue-preserving strategy. When tailored to the patient, it provides high satisfaction and reliable therapeutic benefit.