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                                                     Painless Laser Piles and fistula surgery.

Conventional piles surgery consists of ligation of the veins causing piles at the top of anal canal. This involves a lot of cutting and exposure to the anal sphincter. This results in the following
1. Spasm of Anal sphincter >> This causes the post operative pain faced by patients. It can extend to 2 months for some patients.
2. Damage to Anal sphincter >> This causes shrinking of anal opening in most cases. Once this develops the patient will have a lifelong need for laxatives to form loose stools.
In our experience this complication is as high as 20% of operated cases. It is more in 3rd degree piles.
3. Sometimes the damage can cause non-functioning of Anal sphincter  and the patient can loose control over his/her motions.

Above complications happen in best of surgeons hands and therefore anyone is prone to develop them.

Painless piles and fistula by laser  follow the following principles
   1. The Anal Sphincter is not touched or exposed.
   2. No cutting of tissues at the Anal canal.
   3. The primary cause of constipation is tackled by modifications in diet.
   4. There should be no need of drugs beyond 3 weeks.

                                                Laser Ablation of Piles and fistula

Laser has revolutionized medicine in many ways. Laser allows the surgeon to be fast as well as precise in surgery. Minimal trauma and fast recovery are hallmarks of laser medicine. Laser minimizes body reaction ensuring a fast and painless recovery in most cases. Laser ablation of piles allows the doctor to precisely focus attention to veins forming piles leaving all surrounding tissue intact, including the lining over the piles.

Minimal tissue handling allows the patient to have an excellent recovery from pain and constipation and bleeding in a very short time.

 Q. What is the cause of pain after non laser operation.?

A. Pain is caused by cutting of tissues around piles.

 Q What causes recurrence of Piles?

A Recurrence is caused due to non-relief of original constipation as well as narrowing of anal canal after surgery called Partial Anal Stenosis.

This condition actually leads to patient becoming life long dependent on laxatives to pass motions.

This problem is negligible in Laser Ablation of piles due to excellent relief of constipation and no possibility of Partial Anal Stenosis.

 Q. Is there dietary restriction after Laser Ablation of piles?

A. Good dietary habits are always better in long run., but there is no specific dietary restriction after Laser Ablation of Piles. All patients can go to the diet of their choice as long as there is no problem with their medical conditions if any.

 Given below is an approximate comparison between Conventional Surgery and Laser Ablation of piles/fistula



Conventional surgery

Laser Ablation of Piles/fistula

Post op pain

2-4 weeks (major)

1-2 days(minor)

Time of Surgery

30-45 mins

5 mins




Constipation relief



Join work

2-4 weeks

2 4 days

Post op anal bath

3-4 weeks


Anal canal narrowing

30-50% cases


Dietary restriction

Non veg/spices

Practically negligible

Post op medication

2-4 weeks

2 days

Low Hb

Not possible without blood



30-50% cases

Negligible if no constipation



Laser fistula ablation after surgery

At presentation multiple fistulas Week 2 after opn  
Week 3 after opn Week 5 All healed



  ecoring Fistulectomy

Decoring fistulectomy showing the proceedure and specimen showing no skin removal and total removal of the fistula. The fistula is removed from below the surface of skin. hence there is very minimal pain. The patients typically are discharged on 2nd day. They are at work which can involve sitting , on 4th day. Since there is practically no cutting of the anal sphincter muscle there is no danger of the routine complication of Anal stenosis or narrowing of anal opening.(This complication can make the patient dependent on drugs for making motions  soft ,for life). There is no danger of Anal Incontinence or loosing control over stools.