Hemorrhoid laser surgery involves the use of an infrared beam of light to burn and remove hemorrhoids. Lasers used include Nd:YAG (neodymium-doped yttrium aluminum garnet) for internal hemorrhoids and carbon dioxide for external hemorrhoids. After surgery you will be stitched up with absorbable stitches. If you take medications such as anti-clotting drugs, your doctor will advise you about whether you need to stop these before surgery.

Advantages and disadvantages of Hemorrhoid laser surgery.
Pros & cons of laser

Pros
The procedure is fairly painless
You can go home the same day in most cases
Safe, with no steam or smoke required
Minimal blood loss
A quick operation time meaning less anaesthetic is required
Faster wound healing and hemorrhoid operation recovery than other treatments
Multiple beams (narrow and wide range) mean that tissue can be targeted effectively
Does not kill cells, meaning there are fewer complications after the operation
Kills any bacteria around the area
Can be used for any grade of haemorrhoid up to grade 4
98% success rate in a study of 750 patients with flare-ups
Cons
May not be available everywhere as the treatment is quite expensive
Bleeding during surgery may be more difficult to deal with than other methods
May not be suitable for all hemorrhoids
Although smaller studies show some benefit, the most rigorous clinical trials have not found it more effective than other treatments
Sometimes more expensive than traditional surgery (or may be less depending on the treatment center and methods used)

Your treatment may look something like this

hemorrhoid laser surgery
Risks and side effects of hemorrhoids laser surgery.
Short-term

The main complications during and after surgery are bleeding, burning, infection, skin tags, reaction to the anaesthetic and closure of the canal. One study reported rates of burns as 28% and skin tags as 33%. Pain with laser surgery has been reported to be 65% less than standard hemorrhoidectomy at one week after surgery, and return to work was 100% sooner. This has been backed up by another study of ND:YAG lasers in 50 patients, where 88% of patients treated with laser compared with 44% of hemorrhoidectomy returned to work at one week. Another study found one patient with bleeding (with a medical blood condition) during the procedure.

Long-term

Patients who had received hemorrhoid laser surgery were followed up after one year to look for long-term complications. In total, 3.5% had some form of complication, including swelling (2%), bleeding (0.5%) or abscesses (0.5%). Narrowing of the canal was not seen in any patients, and none required repeat treatment at one year.

Patient reports
People who have had laser surgery have varying views on the treatment. One remarked, “I was excited to get this laser surgery for hemorrhoids… it is well recommended to examine the healthcare center you are considering to visit, sometimes there is a difference between guarantees and ads in reality”, and mentioned the successes with laser eye surgery. Another gave the treatment 4 out of 5 stars, “based on the price of the laser surgery for hemorrhoids compared to the quality” and described it as a “wonderful service”.

Comparison with other treatments
One clinical trial compared laser therapy with rubber band ligation in 60 patients with grade 2 and 3 hemorrhoids. Neither group were given any anaesthesia. Complications during the operations and the time taken to perform the procedures were comparable. Pain scores were lower with laser therapy (1.1 versus 2.9) and symptoms were completely better in 90% of people with laser versus 53% with ligation. The grading for hemorrhoids reduced by one in 80% of those treated with laser and 40% with banding. Laser treatment was more expensive than banding in this study.

Another looked of 40 patients at the difference between laser surgery using the carbon dioxide laser and Milligan Morgan hemorrhoidectomy. They found no difference in use of painkillers although pain scores during the first bowel motion after surgery were higher in the laser group. The rates of complications, healing times, recovery times and patient satisfaction scores were similar in the two groups.

A further trial looked at the treatment of advanced hemorrhoids with Nd:YAG laser compared with ‘cold scalpel’ hemorrhoidectomy. They found the Nd:YAG laser was more expensive than scalpel surgery, and had more wound inflammation and separation at ten days. Other outcomes were similar between groups.

Future directions
A recent study has investigated the use of a scanner to assist laser surgery in 350 patients. Overall, it found the technique to be superior to laser surgery without scanning. 96% of patients used painkillers for up to three days following the operation. 1.42% described their pain as ‘strong’ for a few days but only 0.6% experienced this for over a week. All of the patients were healed by the 40th day after the operation. Complications included nipple bleeding, narrowing of the canal and skin tags. The average return to work day was three days after the operation.

For more information, please watch this YouTube video from The Hemorrhoid Centers at:

Need to read more ? here is some useful websites about hemorrhoids:

Reviews from people who just had laser hemorrhoid surgery… again!
American Gastroenterologist association
Pain excrutiating after hemorrhoid laser surgery, what do i do?
Treat hemorrhoids with surgery in depth review
The hemorrhoid laser procedure technique vs rubber band ligation
Hemorrhoid forum
http://nyp.org/health/digest-hemorrd.html
New York Gastroenterologist Doctors:
New York Downtown Faculty Prac
Forrest Manheimer
156 William St Fl 7
New York, NY 10038
(646) 588-2500
Kalryur Venkat MD
Rajiv Uppal
122 Fulton St Fl 4
New York, NY 10038
(212) 227-3670
David S Zimmon MD FACP
David S Zimmon
170 William St Ste 5A
New York, NY 10038
(212) 312-5090
New York Gastroenterologist Doctors google map
Mark Chu
13-17 Elizabeth St Ste 608
New York, NY 10013
(212) 219-8031
complete map from google for gastroent
References

1. Healing Natural Oils. http://www.amoils.com/treatment/hemorrhoids/laser-hemorrhoid-surgery.html. Accessed 04/06/13.

2. Giamundo P, et al. The hemorrhoid laser procedure technique vs rubber band ligation: a randomized trial comparing 2 mini-invasive treatments for second- and third-degree hemorrhoids. Dis Colon Rectum. 2011 Jun;54(6):693-8.

3. Jahanshahi A, et al. Diode laser for treatment of symptomatic hemorrhoid: a short term clinical result of a mini invasive treatment, and one year follow up. Pol Przegl Chir. 2012 Jul;84(7):329-32.

4. Laser Surgery for Hemorrhoids. http://www.slideshare.net/naturalremediesforhemorrhoids/laser-surgery-for-hemorrhoids. Accessed 05/06/13.

5. Fleshman J, et al. Advanced technology in the management of hemorrhoids: Stapling, laser, harmonic scalpel, and ligasure. Journal of Gastrointestinal Surgery. 2002;6(3):299-301.