Hemorrhoids and anal fistulas can be painful and persistent, but treatment doesn’t have to be. Laser therapy is a modern, minimally invasive option that targets the problem directly—reducing discomfort, promoting faster healing, and helping you get back to living without interruption.
If you're dealing with painful hemorrhoids or a recurring anal fistula, you deserve a solution that doesn't make recovery worse than the problem. At Your Friendly Proctologist, Dr. Albert Chung offers advanced laser treatment options for both conditions, sphincter-sparing where possible, and built around getting you healed without dragging out the discomfort.
LHP is a minimally invasive procedure that uses focused laser energy to shrink internal hemorrhoids without cutting them off. No incisions, no stitches, and far less pain than a traditional hemorrhoidectomy.
Once the area is numbed with local anesthetic, a tiny incision is made next to the hemorrhoid. A laser fiber-optic instrument is then inserted directly into the hemorrhoid to deliver targeted energy. The blood vessels shrink and scar internally, which reduces swelling and relieves bleeding, itching, and pain.
Dr. Chung performs LHP either in-office while you're awake, or in an operating room under anesthesia, depending on what makes sense for your case.
FiLaC is a cutting-edge treatment for anal fistulas that preserves muscle and minimizes the risk of incontinence. It uses laser technology to target the internal tract (the tunnel) created by the fistula.
First, the tunnel is located and cleaned. Then a fine laser fiber is inserted to apply controlled energy along the full length of the tract. An internal stitch is placed at the internal opening of the anus, and the outer opening is left open so any infection can drain safely.
Laser treatment is most effective for patients who want to avoid the long, painful recovery associated with conventional surgery. You might be a candidate if you're experiencing:
That said, not every patient is a match, and not every hemorrhoid or fistula is best treated with a laser. Dr. Chung uses his surgical experience to evaluate the size, location, and complexity of each case and recommends the right technique: laser, surgical excision, or a hybrid approach.
Dr. Chung doesn't just perform the procedure and send you on your way. As Your Friendly Proctologist, he:
He also understands how deeply personal and frustrating anal surgery can be. That's why you'll never be rushed, ignored, or left wondering what's next.
The procedure itself is one part of the story. The prep beforehand and the recovery after both matter for how well things go.
You'll receive specific prep instructions in advance. Following them precisely makes a real difference in how the first few days feel.
For fistula surgery, post-op care is even more important. Dr. Chung places patients on a personalized wound care program with scheduled follow-ups to ensure optimal healing.
His priority isn't just getting you through the procedure. It's helping you fully recover with minimal setbacks.
LHP works on internal hemorrhoids. It is at its best for Grade II and Grade III hemorrhoids that bleed or prolapse and have not responded to fiber and banding, or in patients who want to avoid the recovery of a hemorrhoidectomy. It is a poor fit for external hemorrhoids and skin tags, which sit in skin that is full of pain nerves and are better handled by excision, and for Grade IV hemorrhoids that are permanently prolapsed, where hemorrhoidectomy remains the most reliable option. Patients with mixed internal and external disease are sometimes treated with LHP for the internal component and a small excision for the external one in the same session.
Dr. Chung confirms the grade with an anoscopy at your first visit. If you are not a candidate, he tells you, and explains what would work better. Learn how hemorrhoids are graded on the hemorrhoid treatment page.
These are the three procedures most Orange County patients end up choosing between. Each has a job.
| Rubber band ligation | Laser hemorrhoidoplasty (LHP) | Hemorrhoidectomy | |
|---|---|---|---|
| Hemorrhoid grade | I to III internal | II to III internal | III to IV, external, mixed |
| How it works | Band cuts off blood supply; tissue falls away | Laser fiber shrinks and seals the hemorrhoid from inside | Hemorrhoidal tissue is surgically removed |
| Anesthesia | None | Local, or sedation in a surgery center | General or spinal |
| Procedure time | 5 minutes | 20 to 30 minutes | 30 to 60 minutes |
| Pain afterward | Pressure for 1 to 2 days | Mild to moderate for 3 to 5 days | Significant for 1 to 2 weeks |
| Return to desk work | Same or next day | 2 to 4 days | 7 to 14 days |
| Recurrence | Low to moderate; repeatable | Low to moderate; repeatable | Lowest |
| Cutting or stitches | None | None; a pinpoint entry only | Yes |
Randomized trials comparing LHP with conventional hemorrhoidectomy consistently show less postoperative pain, less bleeding, shorter procedure time, and a faster return to normal activity with the laser. The tradeoff is a somewhat higher chance of recurrence over the following years, because the hemorrhoidal tissue is shrunk rather than removed. Studies comparing LHP with rubber band ligation report similar short-term symptom control with fewer repeat sessions needed after laser. Dr. Chung reviews this tradeoff with every patient: LHP is the right choice when a gentler recovery matters most and the hemorrhoids are Grade II or III; hemorrhoidectomy is the right choice when the priority is the lowest possible chance of ever dealing with them again.
Fistula surgery is a balance between healing the tract and protecting the sphincter muscle that controls continence. This is how the sphincter-sparing options compare with the traditional one.
| Fistulotomy | FiLaC (laser closure) | LIFT procedure | |
|---|---|---|---|
| Best for | Simple, low fistulas with little muscle involved | Transsphincteric fistulas where muscle must be preserved; recurrent fistulas | Transsphincteric fistulas with a well-defined tract |
| Sphincter muscle | Divided | Preserved | Preserved |
| Healing rate | Highest, above 90 percent for simple fistulas | Roughly 60 to 70 percent primary healing in published series; can be repeated | Roughly 65 to 75 percent in published series |
| Continence risk | Present, rises with the amount of muscle divided | Minimal | Minimal |
| Wound | Open wound that heals over weeks | Small external opening left to drain | Small incision between the sphincters |
| Return to work | 1 to 2 weeks | 2 to 5 days | 1 to 2 weeks |
For fistulas that have already recurred after another operation, or in patients with Crohn's disease, FiLaC has the added advantage of not burning any bridges: if it does not fully heal the tract, every other option remains available. Dr. Chung frequently combines a seton for several weeks before FiLaC to let the tract mature, which improves the odds of closure. See the anal fistula treatment page for the full range of options.
Coverage for LHP and FiLaC varies by insurer and plan. Fistula surgery, including laser closure, is generally treated as medically necessary. Laser hemorrhoidoplasty is covered by some plans and treated as elective by others, in which case a self-pay option is available. Before anything is scheduled, the office verifies your benefits and gives you a written estimate of any out-of-pocket cost. If you are comparing laser treatment costs across Orange County clinics, ask each one whether the quoted price includes anesthesia, facility fees, and follow-up visits, because those are where estimates usually differ.
Patients searching for laser hemorrhoid treatment near me or FiLaC surgery often find that very few surgeons in Southern California offer both procedures, and fewer still are fellowship-trained colorectal surgeons who can also perform every conventional alternative. Dr. Chung offers laser treatment as one tool among many, which is what lets him recommend it only when it is the right one.
Dr. Chung sees patients at 30212 Tomas, Suite 365, Rancho Santa Margarita, CA 92688, off the 241 toll road in South Orange County. Patients come from Mission Viejo, Lake Forest, Irvine, Laguna Hills, Laguna Niguel, Aliso Viejo, San Juan Capistrano, Ladera Ranch, Trabuco Canyon, Santa Ana, and across Orange County. Most new patients are seen within days, and a first visit usually includes the exam, a plain-language explanation, and a treatment plan the same day.
Not ready for an in-person visit? Dr. Chung also offers online video consultations. Read what patients say on the reviews page.
Far less than a hemorrhoidectomy. LHP involves no cutting or stitches, so most patients describe soreness and pressure for three to five days rather than sharp pain. Over-the-counter pain medication and sitz baths are usually enough. Bowel movements are the most uncomfortable moments during the first week, which is why stool softeners are started before the procedure.
Most patients are back to desk work within two to four days and to full activity, including exercise, within two weeks. Internal healing continues for four to six weeks, and bleeding and prolapse improve progressively over that period as the treated tissue shrinks.
No. LHP is designed for internal hemorrhoids. External hemorrhoids and skin tags sit in skin with many pain nerves and are treated by excision. If you have both internal and external disease, Dr. Chung may combine LHP with a small external excision in the same session.
Published series report primary healing in roughly 60 to 70 percent of fistulas after a single FiLaC procedure, with higher rates when a seton is used first to mature the tract. Because FiLaC preserves the sphincter, it can be repeated, and it does not prevent any other procedure from being done later if needed.
Both, depending on the case. Straightforward LHP for one or two hemorrhoids is often done in Dr. Chung's Rancho Santa Margarita office under local anesthetic. Larger cases and all FiLaC procedures are done at an outpatient surgery center with sedation. No one stays overnight.
Fistula surgery, including FiLaC, is generally covered as medically necessary. Laser hemorrhoidoplasty coverage varies by plan; some cover it like any other hemorrhoid procedure and some consider it elective. The office checks your benefits and provides a written estimate before scheduling.
Yes. Because LHP does not remove tissue or create scarring in the anal canal, it can be repeated, and it does not rule out banding or hemorrhoidectomy later. Recurrence is more likely if constipation and straining continue, so the habits that caused the hemorrhoids still need to change.
The best way to know which approach fits your situation is a conversation. Book a consult and Dr. Chung will walk you through your options.
Book a consultation Call (714) 988-8690Prompt diagnosis and treatment greatly improve colorectal cancer outcomes. Call Dr. Albert Chung’s colorectal clinic in Orange County.
