Laser Hemorrhoidoplasty
Laser hemorrhoidoplasty (LHP) uses diode laser energy to coagulate and shrink hemorrhoidal tissue from within, without excising it — a newer, less invasive alternative to traditional hemorrhoidectomy with a smaller but growing body of research behind it.
- A diode laser fiber is inserted into the hemorrhoidal tissue, causing controlled coagulation that shrinks it over time, without cutting or removing tissue.
- Recent studies report notably lower pain than traditional hemorrhoidectomy, with quick recovery times.
- As a newer technique, its long-term recurrence data is less extensive than for traditional hemorrhoidectomy or even stapled hemorrhoidopexy.
How it works
A thin laser fiber (commonly a 1470 nm diode laser in recent studies) is inserted directly into hemorrhoidal tissue, delivering energy that causes controlled coagulation — shrinking the tissue and reducing its blood supply without an excisional cut. This distinguishes it from traditional hemorrhoidectomy (which removes tissue) and positions it alongside other non-excisional approaches like HAL-RAR, though using a different energy source and technique.
What recent research shows
A 2024–2025 prospective study of 140 patients with grade I–IV hemorrhoidal disease found: average procedure time under 20 minutes, minimal blood loss, and postoperative pain (on a standard visual analog scale) dropping from a mean of 2.1 on day one to just 0.3 by day seven — notably low compared to the pain profile typically described for traditional excisional hemorrhoidectomy. Median recovery time in this study was just 3 days, though longer for more advanced-stage disease. No recurrences were observed at 12 months in this particular study, though this is a shorter follow-up period than exists for more established techniques.
Complications and what predicts them
In the same study, early complications increased notably with disease stage — from 10% in grade II disease up to 68% in grade IV — and higher Goligher grade was also linked to increased likelihood of late bleeding and prolonged recovery. This is a useful, practical finding: laser hemorrhoidoplasty appears to work best, with the fewest complications, in earlier-stage disease, and the trade-offs shift for more advanced grade IV disease.
How it compares to other options
Compared to traditional excisional hemorrhoidectomy, laser hemorrhoidoplasty studies generally report meaningfully less bleeding, shorter operative time, and faster recovery. Compared to other non-excisional options like HAL-RAR or stapled hemorrhoidopexy, it represents another entry in the broader trend toward less invasive alternatives to traditional excisional surgery, each with its own specific technique and evidence base.
A note on the evidence base
As a comparatively newer technique, laser hemorrhoidoplasty has a smaller and more recent body of long-term outcome data than traditional hemorrhoidectomy or even stapled hemorrhoidopexy, which has itself been studied for over two decades. Promising short-term results don’t yet have the same depth of long-term recurrence data behind them — worth discussing directly with a surgeon who has specific experience with this technique.
When to consider this option
- Earlier-stage hemorrhoidal disease (grade I–III), where reported complication rates are lower
- A surgeon with specific training and equipment for this technique
- A priority on minimizing pain and recovery time, while accepting a shorter track record on long-term recurrence compared to more established surgical options
This page is for general education, based on recent published studies. As a newer technique, discuss with your surgeon their specific experience and the most current available evidence.