Relevance and applications of Laser-Assisted Hemorrhoidoplasty (LHP)

Hemorrhoids are a common anorectal condition, often affecting the quality of life of patients due to pain, bleeding, and discomfort. While Grade 2 and 3 hemorrhoids have traditionally been managed through conventional hemorrhoidectomy, the postoperative complications associated with this method—such as pain, prolonged recovery, and potential damage to the anal sphincter—have prompted the search for safer, less invasive alternatives. One such innovation making significant strides is Laser-Assisted Hemorrhoidoplasty (LHP). This minimally invasive, sphincter-sparing procedure is redefining anorectal surgery by offering excellent clinical outcomes with reduced patient morbidity.

What is LHP?

Laser-Assisted Hemorrhoidoplasty involves the application of a radial-emitting laser fiber directly into the hemorrhoidal pile. The energy delivered causes controlled shrinkage of the hemorrhoidal tissue without excision, minimizing trauma to the surrounding structures, particularly the sensitive anoderm and sphincter muscles.

Minimally Invasive, Maximally Effective

Unlike traditional hemorrhoidectomy, which involves excision and ligation of the hemorrhoidal tissue, LHP is a non-excisional technique. This results in significantly reduced postoperative pain, shorter recovery time, and minimal bleeding. Patients undergoing LHP often resume daily activities within a few days, compared to the weeks of recovery often associated with conventional surgery.

This reduced downtime is particularly beneficial in the working population, who might otherwise delay treatment due to the anticipated impact on their professional lives.

Sphincter-Sparing Advantage

One of the most compelling benefits of LHP is its sphincter-preserving nature. Conventional surgeries pose a small but real risk of damaging the anal sphincter, which can lead to complications like fecal incontinence. LHP, by avoiding incisions in the anoderm and targeting only the hemorrhoidal cushion, preserves the sphincter’s structural and functional integrity. This makes it a suitable option for patients concerned about long-term continence and anorectal function.

Clinical Outcomes and Evidence

Supporting Studies

• A 2017 study published in Techniques in Coloproctology compared LHP with Milligan-Morgan hemorrhoidectomy and reported significantly less postoperative pain, faster recovery, and greater patient satisfaction in the LHP group. 
• Another multicentric study involving 200 patients found no major complications, with over 90% of patients reporting improvement in symptoms and quality of life within one month of surgery. 
• Recurrence rates post-LHP have been reported between 5–8%, comparable to traditional surgery, but with far better postoperative comfort and outcomes. 

Postoperative Quality of Life (QoL) Improvements

Quality of life post-treatment is a critical parameter in modern surgical practice. LHP has shown superior outcomes in this regard:

• Minimal pain eliminates the need for prolonged analgesic use. 
• Absence of wound care and dressing promotes better hygiene and ease of recovery. 
• Early return to work and normal activity reduces the psychological burden of surgery. 

These QoL improvements are particularly significant in younger patients and working professionals who value quick recovery and minimal disruption to their daily lives.

Changing the Surgical Landscape

As technology continues to evolve, the role of lasers in surgery has expanded. LHP is not merely an alternative—it represents a paradigm shift in the management of hemorrhoidal disease. With its minimally invasive approach, reduced complication rates, and high patient satisfaction, LHP is increasingly being adopted as the preferred choice for Grade 2 and 3 hemorrhoids.

Laser-Assisted Hemorrhoidoplasty is more than a technological advancement—it is a patient-centered solution that aligns with the modern demand for minimally invasive and function-preserving treatments. For patients with Grade 2 or 3 hemorrhoids, LHP offers a safe, effective, and sophisticated alternative to conventional surgery. As clinical evidence continues to mount, it’s clear that LHP is set to redefine best practices in anorectal surgery.