Minimally Invasive Piles Treatment: Comparing LHP, RFA, and Stapler Surgery

Minimally invasive procedures have changed piles (hemorrhoids) management — offering less pain, faster recovery and excellent outcomes compared to older open surgeries. This guide compares the three commonly used minimally invasive options: LHP (Laser Hemorrhoidoplasty), RFA (Radiofrequency Ablation), and Stapler Hemorrhoidopexy (PPH), so you can understand which might be suitable for you.

1. LHP — Laser Hemorrhoidoplasty

What it is: LHP uses a laser fiber inserted into the hemorrhoidal plexus to coagulate and shrink the hemorrhoidal cushions while preserving the mucosa and sphincter.

Best for: Grade II–III hemorrhoids, patients who want quick recovery and minimal post-op pain.

  • Benefits: Minimal bleeding, less postoperative pain, office/daycare procedure, quick return to daily activities.
  • Risks: Rare thermal injury if improperly used, mild transient discomfort.
  • Recovery: Most patients return to work within 24–72 hours. Stool softeners and high-fiber diet recommended.

2. RFA — Radiofrequency Ablation

What it is: Radiofrequency energy is applied to hemorrhoidal tissue to cause controlled ablation and subsequent fibrosis which reduces the hemorrhoid size and bleeding.

Best for: Grade II–III hemorrhoids, patients with bleeding or symptomatic cushions wanting sphincter-sparing therapy.

  • Benefits: Low pain levels, targeted tissue effect, quick procedure often under local/regional anesthesia, good hemostasis.
  • Risks: Rare post-op thrombosis, transient urinary retention in some patients.
  • Recovery: Return to normal activity typically within 2–4 days; follow-up for diet and bowel management.

3. Stapler Hemorrhoidopexy (PPH / Stapler Surgery)

What it is: Using a circular stapling device, prolapsed hemorrhoidal tissue is resected and the remaining tissue is repositioned higher in the anal canal (above the pain-sensitive dentate line).

Best for: Prolapsed internal hemorrhoids (Grade III, early Grade IV) where repositioning rather than excision is preferred.

  • Benefits: Less pain than conventional hemorrhoidectomy, shorter hospital stays, effective for prolapse.
  • Risks: Rare but serious complications reported (stapler misfire, pelvic sepsis, severe bleeding) — careful case selection & experienced surgeon essential.
  • Recovery: Most patients resume daily activities in 5–10 days; avoid heavy lifting for 2–4 weeks.

How the Procedures Compare — Quick Table

FeatureLHP (Laser)RFAStapler (PPH)
Pain (relative)LowLowModerate
Recovery Time24–72 hrs2–4 days5–10 days
Best ForBleeding, small prolapseBleeding, symptomatic cushionsProlapsed hemorrhoids
RecurrenceLow to moderateLow to moderateLow (if selected correctly)
Hospital StayDaycareDaycare/short stayShort stay (same day or overnight)

Which Option Is Right for You?

Choosing between LHP, RFA and Stapler depends on:

  • Grade and type of hemorrhoids (bleeding vs. prolapse)
  • Your general health and anesthesia tolerance
  • Recovery expectations and work/responsibilities
  • Surgeon experience and available equipment

A clinic consultation with physical exam and, if needed, proctoscopy helps determine the best individualized treatment plan.

Preparing for Minimally Invasive Piles Treatment

  • Pre-op evaluation and blood tests.
  • Bowel preparation as advised by your surgeon.
  • Discuss anticoagulants and medications with your doctor.

Post-Op Care & Recovery Tips

  • High-fiber diet and 2–3 litres of water daily to avoid constipation.
  • Use stool softeners as prescribed.
  • Warm sitz baths for 10–15 minutes to reduce discomfort.
  • Avoid heavy lifting for the recommended period.

Risks & When to Seek Help

Minor bleeding, mild discomfort and temporary urinary retention are common early after treatment. Seek immediate care if you experience:

  • Heavy or persistent bleeding
  • Fever or signs of infection
  • Severe pain not controlled with prescribed medications

“Minimally invasive techniques like LHP and RFA have transformed piles management — less pain, faster recovery, and excellent patient satisfaction when matched correctly to the patient.”

Dr. Ramesh Babu, Chief Gastro Surgeon, Chief Colorectal Surgeon

Costs & Practical Considerations

Costs vary by procedure, hospital facility, anesthesia type and whether any additional tests are needed. Laser and RFA are typically daycare procedures and can be cost-effective due to faster return to work. For accurate pricing, contact our clinic for a personalized quote.

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