LASER APPLICATIONS IN ANORECTAL PATHOLOGIES: PRINCIPLES, TECHNIQUES, AND CLINICAL OUTCOMES

Abstract

Background: Anorectal disorders such as hemorrhoids, fistula-in-ano, fissure-in-ano, pilonidal sinus, and anal condyloma are common conditions that significantly affect quality of life. Conventional surgical procedures, though effective, are often associated with postoperative pain, bleeding, prolonged wound healing, and hospital stay. Over the last two decades, laser technology has emerged as a minimally invasive alternative in proctology, offering precise tissue handling with reduced collateral damage. Aim:
To evaluate the principles, techniques, and clinical outcomes of laser applications in the management of anorectal pathologies. Objectives: To understand the basic principles of laser use in anorectal surgery To review commonly employed laser techniques for various anorectal disorders. To assess clinical outcomes, safety, and advantages of laser-based procedures. Materials and Methods: A narrative review of available literature was conducted using classical surgical texts, contemporary proctology references, and peer-reviewed articles indexed in PubMed, Google Scholar, and Scopus. Studies focusing on laser hemorrhoidoplasty, laser fistula closure, laser fissure procedures, and laser treatment of pilonidal sinus were analyzed with emphasis on technique, indications, advantages, limitations, and outcomes. Results: Laser procedures demonstrated favorable clinical outcomes across various anorectal conditions. Most studies reported reduced intraoperative blood loss, minimal postoperative pain, early ambulation, shorter hospital stay, and faster return to routine activities compared to conventional surgeries. Recurrence rates were comparable or lower in selected indications when proper case selection and technique were followed. Complication rates such as infection, incontinence, and delayed wound healing were generally low. Discussion: The effectiveness of laser therapy is primarily attributed to its precise photothermal action, which allows controlled tissue ablation, coagulation, and fibrosis with minimal damage to surrounding structures. However, outcomes are influenced by surgeon expertise, type of laser used, disease stage, and patient factors. High equipment cost and limited long-term data remain important concerns. Conclusion: Laser applications represent a safe and effective minimally invasive option in the management of selected anorectal pathologies. When used judiciously, laser techniques can improve patient comfort and postoperative recovery. Further large-scale randomized controlled trials with long-term follow-up are required to establish standardized protocols and definitive clinical guidelines.