Laser haemorrhoid treatment that shrinks piles from inside, without cutting tissue away.
Dr Daniel Lee checks which grade you have first, because laser suits some piles very well and others not at all.
What a typical laser haemorrhoid procedure looks like with Dr Lee.
These are Dr Lee's usual figures for a straightforward case. Your plan depends on what he finds, and it is set out before anything is booked.
Heat from a fine fibre shrinks the pile under its own lining.
A haemorrhoid is a swollen cushion of blood vessels inside the back passage. In laser haemorrhoidoplasty (LHP), Dr Lee makes a pinhole entry at the base of the pile, at the edge of the anus (the anal verge), and slides a thin fibre up under the lining, in the submucosal layer. He makes no cuts inside the canal, which keeps bleeding down, and he steers the fibre by feel with his finger and by its red aiming light.
The fibre's tip gives off laser energy all the way round (a radial fibre, 1470 nm diode laser). That energy turns into gentle heat, which clots the vessels inside the pile. Over the next few weeks the treated tissue firms up and shrinks (doctors call this fibrosis), and the cushion settles back into place. Surgical lasers aren't new: surgeons in Boston were using them for throat surgery in 1972.
The usual dose, as Dr Lee teaches it, is a few short pulses at three points along each pile: 2 at the top, about 0.5 to 1 cm above the dentate line, then 3 and 3 lower down. He keeps the total under 350 joules per pile, because the more energy a pile takes, the higher the risk of soreness and complications.
Because the heat works under the lining and above the dentate line (the sensitive line inside the canal), the skin of the canal, the anoderm, is not cut away, and there's no open wound on the skin to heal. It isn't a cut-out operation, which is why the first week tends to be easier than after conventional piles surgery.
- The pile: a swollen cushion under the lining
- Pinhole entry at the base of the pile
- Heat at the fibre tip shrinks and seals the cushion
- The dentate line, the sensitive line the heat stays above
What the laser does, in three drawings
I like to treat my patients using minimally invasive surgery whenever possible. And that means a smaller cut, less pain and faster recovery for them.
The piles problems laser haemorrhoidoplasty is used for.
Most piles settle with more fibre, more water and a short course of creams. It is worth getting checked when they don't, or when they keep coming back.
- Bright red blood on the paper or in the bowl after a bowel motion
- A soft lump that comes down when you strain and goes back up
- Itching, discomfort or a feeling of pressure that keeps returning
- Piles that came back after banding or an earlier operation
Bleeding from the back passage should be checked properly.
Bleeding with a change in bowel habit, weight loss, or dark blood mixed into the stool needs looking into, because other conditions can bleed in the same way. Dr Lee may suggest a colonoscopy before treating the piles. A sudden, very painful hard lump is usually a clotted pile, and that's treated differently.
Laser suits some piles very well, and others not at all.
Dr Lee's rule is simple: match the treatment to the pile. Here's how he decides, based on the grade you have and what has been tried before.
Laser is a good fit for
- Grade 2 and 3 internal piles, where laser on its own is usually enough
- Grade 4 piles, with added steps such as tying the feeding artery (haemorrhoidal artery ligation, HAL) or a lift stitch (mucopexy), after an honest talk about the extra soreness this brings
- Piles that have come back after earlier treatment, including after laser, because LHP keeps the tissue and can be repeated
Another option may serve you better
- Very large piles that stay outside all the way round, which usually need conventional surgery
- Skin tags on their own: laser shrinks the pile inside, it doesn't remove skin tags
- A clotted, very painful pile, which is treated as its own problem first
- Bleeding that hasn't been checked yet, where a scope comes first
From first visit to back at the gym, one step at a time.
Here is what happens at each stage, and roughly when.
- First visit
Examination and a clear diagnosis
Dr Lee asks about your symptoms, examines the area and looks inside with a short scope. He grades the piles and checks nothing else is causing the bleeding.
- Same visit
A plan that fits your grade
Laser alone, laser with added steps, or a different treatment altogether. He explains why, and what recovery will look like, before anything is booked.
- Procedure day
30 to 60 minutes, home the same day
You'll need someone to take you home.
- First week
Soreness that settles
Expect some soreness and swelling. Stool softeners, warm sitz baths and simple painkillers help.
- Weeks 2 to 6
Review, then back to normal
Dr Lee checks how things have settled. Heavy lifting and the gym wait until about 6 weeks.
How laser compares with banding and conventional piles surgery.
There is not one right treatment for piles. Each option trades comfort now against how much tissue it deals with. Here is how three common piles treatment options compare.
| Option | What it does | Usually for | First week | The trade-off |
|---|---|---|---|---|
| Rubber band ligation | A band cuts off the blood supply and the pile drops off | Grade 1 to 2, some grade 3, done in clinic | A dull ache for a day or two | Often needs repeat sessions |
| Laser haemorrhoidoplasty | Heat under the lining shrinks the pile from inside, nothing cut out | Grade 2 to 3 in the studies quoted; some grade 4 with added steps | Less pain and fewer painkillers than conventional surgery in pooled studies | At one year, no significant difference from conventional surgery in 2 trials; skin tags stay |
| Conventional haemorrhoidectomy | The pile is cut out and the wound heals over weeks | Large grade 3 to 4 piles, or a big outside component | The most sore of the three | Removes the most tissue, including outside lumps |
Pain and one-year results for laser vs conventional surgery come from a 2023 review of 9 studies and 661 patients by surgeons at Singapore General Hospital.
What published research says about laser haemorrhoid treatment.
Results from published studies by other surgeons, not a promise of your result.
41%
Less likely to need painkillers
Than after conventional surgery. A 2023 review of 9 studies, 661 patients.
Day 7
Pain about 4 points lower out of 10
The same review also found less early bleeding and a quicker return to work.
1 year
Similar results
No significant difference in bleeding or prolapse, though symptoms came back a little more often after laser (28.6% against 20.0%). 2 trials.
90%
Symptoms gone at 6 months with HeLP laser
Against 53% after banding, in a 60-patient trial. HeLP finds and seals the small arteries feeding the pile.
Recovery after laser haemorrhoid treatment, and what to expect.
The first bowel movement
It's the thing everyone worries about. You will go home with stool softeners so the first one is soft, and it's usually less sore than after conventional surgery. A warm sitz bath afterwards helps.
Some swelling and spotting
A little swelling and light spotting of blood in the first week or two is normal as the piles shrink. Heavy bleeding, fever or not being able to pass urine are reasons to call the team.
Written guidance to take home
Dr Lee gives you clear written instructions on eating, washing, painkillers and when to call. You won't be left guessing what is normal.
A surgeon who built care around older patients.
For an elderly parent the questions are different. Is the anaesthetic safe? Will recovery be steady? As the former Surgical Lead for Geriatric Surgery at Khoo Teck Puat Hospital, Dr Lee built assessment and recovery pathways around older patients, and co-authored a 10-year review of older patients having colorectal cancer surgery.
A short procedure, often under sedation, with no open wound can suit older patients well. He'll check fitness for anaesthetic first. More about Dr Lee's background.
Fees for laser haemorrhoid treatment, and how MediSave and insurance apply.
Your fee is explained clearly at consultation, before anything is scheduled.
Cost at a glance
Nearest national benchmark: conventional (open) haemorrhoidectomy, TOSP SF836A
Surgeon’s fee (national benchmark)
from SGD 3,270
MOH range SGD 3,270 to 4,142 is for the conventional (open) surgery, not the laser version; MOH publishes no laser-specific figure, so use it as a rough guide only. Dr Lee’s own laser fee may sit inside or outside this range and is confirmed at consultation.
Anaesthetist’s fee (national benchmark)
from SGD 763
MOH range SGD 763 to 1,090. The anaesthetist bills separately; the clinic puts the fee in your written estimate.
Hospital and day-surgery fees
quoted when you ask
Billed separately, and shown in your written estimate.
What will you pay in cash?
It depends on your insurer and plan, so the clinic works it out for you.
Leave your name and mobile, then add your insurer and plan name. No IC or policy number needed. You get the estimate in writing, before anything is booked. The estimate is information only, the decision stays yours.
You can check surgeon fees against the published MOH fee benchmark page.
Anaesthetist and hospital fees are charged separately and vary by hospital.
Paying with MediSave and insurance
Checked for your case
Whether MediSave applies, and how much, depends on how the procedure is coded under MOH's Table of Surgical Procedures and its withdrawal limits. The team checks this for you before you book.
Your plan, confirmed first
Many Integrated Shield Plans cover day surgery for piles, but plans differ. The team helps you get pre-authorisation where your insurer asks for it.
We handle the forms
The team fills in the claim forms and liaises with your insurer where possible, so you can focus on getting better.
The plans we work with.
Dr Daniel Lee practises with Colorectal Clinic Associates (CCA). The clinic works with the insurers below, and the team assists with claims and eligibility checks.
Laser haemorrhoid treatment, answered plainly.
Will the first bowel movement after laser hurt?
Will laser remove my skin tags too?
Is laser haemorrhoidoplasty the same as laser haemorrhoidectomy?
Will I be awake during the procedure?
How much time off work do I need?
Can piles come back after laser treatment?
Is laser haemorrhoid treatment covered by MediSave or insurance?
I'm arranging this for an elderly parent. Is that different?
Laser haemorrhoid treatment at five private hospitals.
Related conditions and treatments.
A short message is enough to begin.
Whether it is for you or a family member, send your name, number and what you're noticing. Dr Lee's team will reply on WhatsApp and find a time and place that suits you.