Las hemorroides y las fístulas anales pueden ser dolorosas y persistentes, pero el tratamiento no tiene por qué serlo. La terapia láser es una opción moderna y mínimamente invasiva que ataca el problema directamente, reduciendo las molestias, acelerando la curación y ayudándole a volver a su vida normal sin interrupciones.
Si sufres de hemorroides dolorosas o de una fístula anal recurrente, te mereces una solución que no haga que la recuperación sea peor que el problema. En «Your Friendly Proctologist», el Dr. Albert Chung ofrece opciones avanzadas de tratamiento con láser para ambas afecciones, preservando el esfínter siempre que sea posible, y diseñadas para que te recuperes sin prolongar las molestias.
La LHP es una intervención mínimamente invasiva que utiliza energía láser focalizada para reducir las hemorroides internas sin extirparlas. Sin incisiones, sin puntos de sutura y con mucho menos dolor que una hemorroidectomía tradicional.
Una vez que se ha adormecido la zona con anestesia local, se realiza una pequeña incisión junto a la hemorroide. A continuación, se introduce un instrumento láser de fibra óptica directamente en la hemorroide para aplicar energía de forma selectiva. Los vasos sanguíneos se contraen y se cicatrizan internamente, lo que reduce la inflamación y alivia el sangrado, el picor y el dolor.
El Dr. Chung realiza la LHP bien en la consulta, con el paciente despierto, o bien en un quirófano bajo anestesia, dependiendo de lo que sea más adecuado para su caso.
FiLaC es un tratamiento de vanguardia para las fístulas anales que preserva la musculatura y minimiza el riesgo de incontinencia. Utiliza tecnología láser para tratar el tracto interno (el túnel) creado por la fístula.
En primer lugar, se localiza y se limpia el conducto. A continuación, se introduce una fibra láser fina para aplicar energía controlada a lo largo de todo el conducto. Se coloca una sutura interna en la abertura interna del ano, y se deja abierta la abertura externa para que cualquier infección pueda drenarse de forma segura.
El tratamiento con láser es más eficaz para los pacientes que desean evitar la recuperación larga y dolorosa asociada a la cirugía convencional. Podrías ser candidato si padeces:
Dicho esto, no todos los pacientes son candidatos adecuados, y no todas las hemorroides o fístulas se tratan mejor con láser. El Dr. Chung se basa en su experiencia quirúrgica para evaluar el tamaño, la ubicación y la complejidad de cada caso, y recomienda la técnica más adecuada: láser, extirpación quirúrgica o un enfoque híbrido.
El Dr. Chung no se limita a realizar la intervención y despedirte. Como tu proctólogo de confianza, él:
Además, es consciente de lo íntima y frustrante que puede resultar una intervención quirúrgica anal. Por eso nunca te meterá prisa, te ignorará ni te dejará sin saber qué va a pasar a continuación.
La intervención en sí es solo una parte de la historia. Tanto la preparación previa como la recuperación posterior son importantes para que todo salga bien.
Recibirás con antelación unas instrucciones específicas para la preparación. Seguirlas al pie de la letra marca una gran diferencia en cómo te sentirás durante los primeros días.
En el caso de la cirugía de fístulas, los cuidados posoperatorios son aún más importantes. El Dr. Chung establece para los pacientes un programa personalizado de cuidado de la herida con visitas de seguimiento programadas para garantizar una cicatrización óptima.
Su prioridad no es solo acompañarte durante la intervención, sino ayudarte a recuperarte por completo con el menor número posible de complicaciones.
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) | Hemorroidectomía | |
|---|---|---|---|
| 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.
| Fistulotomía | FiLaC (laser closure) | Procedimiento LIFT | |
|---|---|---|---|
| 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.
La mejor manera de saber qué enfoque se adapta a tu situación es hablar con nosotros. Reserva una consulta y el Dr. Chung te explicará todas las opciones disponibles.
Reserva una consulta Llame al (714) 988-8690Estamos aquí para escucharte mientras te curas. No dudes en ponerte en contacto con nosotros.
El diagnóstico y tratamiento oportunos mejoran en gran medida los resultados del cáncer colorrectal. Llame a la clínica colorrectal del Dr. Albert Chung en el condado de Orange.
