Author Archives: Dr. N. S. Babu

If you’re dealing with piles and wondering which treatment is best, you’re not alone. Many patients in Hyderabad, Secunderabad, and nearby areas face the same confusion about laser vs traditional hemorrhoid surgery. Both treatments aim to stop bleeding, pain, and swelling, but they work very differently. Laser treatment for hemorrhoids is quick, gentle, and often done in a day-care setting. Traditional surgeries like open or stapled methods may be more painful, but are better for larger or stubborn piles. This blog will help you understand each option clearly so you can choose the best one for your needs. For expert advice, meet Dr. N. Subrahmaneswara Babu, a leading piles specialist in Hyderabad at Hills Gastro & Onco Care and Apollo Hospital.

Hemorrhoids, also known as piles, are swollen and inflamed veins located in the anus or lower rectum. They can develop internally (inside the rectum) or externally (around the anus). Doctors grade them from Grade I (small internal bulges) to Grade IV (large, prolapsed lumps outside the anus that can’t be pushed back in). Common symptoms include:

• Bleeding during bowel movements(often painless)
• Pain or discomfort in sitting or while passing stools
• Itching or irritation around the anus
• A soft or hard lump near the anus
• Mucus discharge and a feeling of incomplete evacuation

Several lifestyle and physical factors contribute to piles. The most common causes include:

• Low-fibre diet: Not eating enough vegetables, fruits, and whole grains causes hard stools.
• Chronic constipation or straining: This increases pressure on the veins around the rectum.
• Long sitting hours: Desk jobs, driving, or long commutes can reduce blood flow in the area.
• Pregnancy & delivery: Hormonal changes and pressure from the uterus strain the pelvic veins.
• Weight lifting & chronic coughing: These raise abdominal pressure.
• Family history: Genetics can make you more prone to weak blood vessels.

When medications, lifestyle changes, and home remedies fail, surgery becomes necessary. Below are the most effective surgical treatments for piles, available in Hyderabad:

This is a minimally invasive, modern method of treating piles using laser energy.

• A thin laser fibre is inserted into each hemorrhoid.
• Laser energy is precisely delivered, shrinking the hemorrhoid from inside and sealing blood vessels.
• No cuts or stitches are made.
• Takes 15–30 minutes and is usually a day-care procedure.
• Less pain, quicker recovery, minimal bleeding.

Highly recommended in top Hyderabad clinics and hospitals.

• Open Hemorrhoidectomy (Milligan-Morgan)
  • Piles are cut and removed using a scalpel or electrocautery.
  • Wounds are left open to heal naturally.
  • Effective for large or external piles, but more painful with longer recovery.
• Closed Hemorrhoidectomy (Ferguson)
  • Same as above, but wounds are closed with absorbable stitches.
  • Reduces healing time slightly but may still cause pain and discomfort.
• Stapled Hemorrhoidopexy (PPH)
  • A circular stapler removes a ring of tissue above the hemorrhoids.
  • Remaining piles are pulled back inside and tacked in place.
  • Best for Grade III-IV internal piles, less painful than open methods.

Both laser and traditional piles surgeries are available with Dr. N. S. Babu at Hills Gastro & Onco Care and Apollo Hospital, Hyderabad.

Here’s a simple breakdown to understand how each of the pile surgeries is done, step by step:

Step-by-Step: Laser Hemorrhoidoplasty

• Anaesthesia: Short general or spinal.
• Laser fibre placement: Inserted into the centre of each pile.
• Energy delivery: 4–6W diode laser shrinks tissue and seals vessels.
• Repeat: Procedure repeated for all affected hemorrhoids.
• No sutures: Tissue shrinks and heals naturally.
• Total OT time: ~14–30 minutes.

Step-by-Step: Traditional Open Hemorrhoidectomy

• Anaesthesia: General or spinal.
• Clamp, cut, and ligatethe pile mass.
• Wound care: Left open (Milligan-Morgan) or stitched (Ferguson).
• Bleeding control: Area packed with gauze.
• Total OT time: ~25–60 minutes.

Dr. N. Subrahmaneswara Babu is one of the top colorectal surgeon in Hyderabad, known for expertise in advanced, minimally invasive techniques with high success and low recurrence.

• Minimal pain: Studies show significantly lower post op pain scores (VAS day 1/7) than traditional surgery
• Fast recovery: Most patients return to work or normal activity within a few days.
• Less bleeding: Laser seals blood vessels, reducing intra operative and post op bleeding.
• No stitches or scars: Sutureless laser technique promotes quick healing with minimal scarring.
• Day-care or same-day discharge: An outpatient setting reduces hospital time and costs.
• Higher patient satisfaction: Better quality of life post procedure.
• Precision and tissue sealing reduce infection and damage.
• Suitable for selected Grade IV: Especially newer methods like Pallam’s hybrid laser sandwich procedure from Osmania General Hospital—a sphincter sparing approach for grade 3/4 that allows same day discharge with minimal complications and low recurrence risk

• Higher recurrence: Some studies find recurrence ~9 % vs ~2–3 % in conventional surgery
• Not suitable for large external piles: Prolapsed or thrombosed external works poorly with laser.
• Numbness or altered sensation: Some reports of nerve scarring causing reduced sensation post-LHP/LIS, improving over months.
• May need followup removal of skin tags: As seen in Reddit user reports, a small tag may remain post procedure, requiring minor followup.
• Cost slightly higher upfront: Laser tends to cost more than open, depending on grade and provider.

• Effective for severe Grade III–IV external and internal hemorrhoids, including large prolapse.
• Low recurrence rate over time (~2–3 %).
• Widely available in most government and private hospitals in Hyderabad.
• Familiar to many surgeons; considered the gold standard for complex cases.

• Considerable postoperative pain: Pain that can last for weeks. Common early complications: urinary retention (20 %), bleeding (2–6 %), infection, anal stenosis and fissure (~1–2 %), incontinence (~0.4 %) or fistula (~0.5 %).
• Longer recovery: 2–3 weeks off work; hospital stay 1–3 days.
• More bleeding and wound care required: Stitches need hygiene care, sitz baths, and dietary fibre.
• Scarring and possible anal stenosis if the wound closes incorrectly.
• Hospital stay and pain meds may increase costs indirectly.

Laser piles surgery is best suited for patients who need a quicker, less painful solution with faster healing. Ideal candidates include:

• Grade II or III internal hemorrhoids that bleed but are not severely prolapsed.
• Busy working professionals who prefer a same-day discharge and quick return to routine.
• Elderly or cardiac patients who cannot tolerate blood loss or a lengthy recovery.
• Women after childbirth with mild prolapse and soft, non-fibrotic tissue.

Dr. N. S. Babu, a renowned piles & gastro surgeon in Hyderabad, evaluates each case personally to determine if laser treatment is the right choice.

In some advanced or complicated cases, open hemorrhoid surgery is still the best and most effective option. This includes:

• Large Grade IV piles that are hard or fibrotic and cannot shrink with laser.
• External piles with big skin tags needing surgical removal.
• Patients who had failed laser or stapler treatment earlier.
• Presence of anal fissures that require cutting and repair during the same surgery.
• N. S. Babu, a trusted piles & fistula surgeon in Hyderabad, recommends open surgery only when it’s truly necessary for long-term success.

Recovery after a piles surgery depends on the type of procedure chosen. Here is a simple breakdown of what to expect after each:

After Laser Surgery:

• Expect mild discomfort, rarely strong pain.
• Most return to light activity within 3–5 days.
• Avoid heavy lifting, a high-fibre diet, and plenty of hydration.
• Follow-ups in 1–2 weeks.
• Only minimal analgesics are needed.

After Traditional Surgery:

• Moderate to severe pain—requires stronger pain relief.
• Recovery takes 2–3 weeks for daily activity; full healing may take 4–6 weeks.
• Daily sitz baths, wound dressing, stool softeners, high-fibre diet.
• Prevent constipation with fluid intake and fibre.
• Close follow-up to monitor healing and complications.

Dr. N Subrahmaneswara Babu, a leading piles surgeon, guides each patient through safe and complete recovery after traditional surgery in Hyderabad.

Choosing between laser vs traditional hemorrhoid surgery depends on your condition, recovery needs, and comfort level. Laser piles surgery is best for those who want quick healing, less pain, and a short hospital visit. It’s a walk-in, walk-out procedure often preferred by office workers and elderly patients in Hyderabad. On the other hand, open hemorrhoidectomy is better for large or recurring piles, offering lower chances of piles coming back in the future.

If you’re searching for piles laser treatment hospitals near me in Hyderabad, or want affordable laser hemorrhoid surgery in Hyderabad, meet the right specialist. Dr. N. Subrahmaneswara Babu, one of the best surgical gastroenterologists in Hyderabad, offers advanced treatment at Hills Gastro & Onco Care and Apollo Hospital. For appointments or queries, call us at 09490808080. A comfortable and permanent solution is just one expert consultation away.