Rubber Band Ligation vs Laser Treatment: Which Is Better for Piles?

When piles lead to ongoing bleeding, discomfort, or tissue prolapse, it may be time to explore medical treatment. Among the options available, two of the most common are rubber band ligation (RBL) and laser piles surgery. Each method aims to relieve symptoms and improve comfort, but they work in very different ways.

If you have been struggling with piles and wondering which treatment suits you better, this article will help you understand how each procedure works and what you should consider before deciding. Keep reading for guidance on how you can make an informed choice for your condition.

What Is Rubber Band Ligation (RBL)?

Rubber band ligation (RBL) is a minimally invasive treatment commonly used for internal haemorrhoids. minimally invasive technique designed mainly for internal haemorrhoids. During this procedure, a small elastic band is carefully placed at the base of the haemorrhoid to stop blood from flowing into it. Over time, the tissue shrinks, dries up, and eventually falls away, leaving behind a small scar that helps reduce the risk of recurrence.

Benefits of Rubber Band Ligation

RBL provides several practical benefits for those managing less severe piles:

• Quick and Convenient: The procedure usually takes only a few minutes and is often completed in a clinic setting without hospital admission.
• No Surgical Incision: RBL does not require cutting or stitches, so patients experience less trauma and a lower risk of complications.
• Minimal Downtime: Most patients can return to their usual routines within one or two days, with only mild soreness that eases quickly.

Considerations and Risks of Rubber Band Ligation

Although RBL is considered safe and effective for Grades 1 to 3 internal piles, some discomfort is common. You may feel pressure or fullness in the rectal area, or notice light bleeding when the treated tissue separates. These effects usually resolve on their own.

In rare situations, infection or more significant bleeding may occur, which requires prompt medical attention. Understanding what to expect and following post-procedure care advice can help you recover smoothly.

What Is Laser Piles Surgery?

Laser piles surgery piles surgery is a newer approach that uses focused laser energy to target and treat haemorrhoidal tissue with precision. The laser helps to remove or shrink the affected tissue while minimising damage to the surrounding areas.

This method can treat both internal and external piles and is often recommended for more advanced cases, such as Stage 3 or 4 haemorrhoids. It may also be an option for patients who did not achieve sufficient relief from non-surgical treatments like RBL.

Benefits of Laser Surgery

Laser piles surgery offers several key advantages for suitable candidates:

• Effective for Multiple Haemorrhoids: Several affected areas can be treated during the same session, making it efficient for those with more widespread symptoms.
• Less Post-operative Discomfort: Patients typically report less pain compared to traditional surgical removal.
• Reduced Swelling and Quicker Healing: The laser energy seals blood vessels during treatment, helping to reduce swelling and promote quicker recovery.

Considerations and Risks of Laser Piles Surgery

As with any surgical procedure, there are potential risks. These may include minor bleeding, infection, or recurrence of symptoms. Recovery may also take slightly longer than with rubber band ligation, particularly for larger or more severe haemorrhoids.

Despite these considerations, laser treatment remains a safe and effective option for patients seeking a precise, minimally invasive approach to haemorrhoid management.

Which Treatment Is Right for You?

The choice between rubber band ligation (RBL) and laser piles surgery depends on several key factors such as the stage of piles, severity of symptoms and your recovery preferences.

Stage of Piles

RBL is generally suitable for early to moderate internal piles (Stages 1 and 2). It works by cutting off the blood supply to the haemorrhoid, causing it to shrink naturally. In contrast, laser surgery is better suited for more advanced cases (Stages 3 and 4), where the piles are larger, prolapsed, or causing persistent bleeding.

Symptoms

Patients with persistent pain, bleeding or prolapsed haemorrhoids may benefit more from laser surgery, as it allows for precise removal of affected tissue. RBL, on the other hand, is ideal for those with smaller, less symptomatic haemorrhoids and can be performed without anaesthesia.

Recovery and Anaesthesia

Recovery after RBL is typically quick, with many people resuming work or regular routines within a day or two. Conversely, laser surgery may require a slightly longer healing period, ranging from several days to a few weeks, depending on how advanced the condition is.

In addition, laser procedures are usually carried out under local or general anaesthesia, while RBL often does not require it. Discussing these options with your doctor can help align the treatment plan with your comfort level and lifestyle.

Ultimately, consulting a colorectal surgeon is the best way to understand which treatment is most suitable for you. If you are experiencing persistent symptoms or are unsure which option to choose, schedule a consultation with Dr Ho Kok Sun today to receive an accurate diagnosis and a treatment plan tailored to your needs. Taking the first step towards relief can help you regain comfort and confidence in your daily life.

About Dr Ho Kok Sun

Dr Ho Kok Sun
Consultant Colorectal and General Surgeon
MBBS (Singapore), M Med (General Surgery) (Singapore)
FRCS (General Surgery) (Edinburgh), FAM (Singapore)

Dr Ho Kok Sun has dedicated more than a decade to the management of piles and haemorrhoids, offering both surgical and non-surgical treatment options. He is the past President of the ASEAN Society of Colorectal Surgeons and the Society of Colorectal Surgeons (Singapore), and a founding member of the Eurasian Colorectal Technologies Association.

Beyond clinical practice, Dr Ho has been actively involved in training medical students and residents and has contributed extensively to medical literature through journal publications and book chapters. He believes that every patient’s treatment should be individualised, focusing on safety, comfort and long-term results.