I have Grade 3 piles — laser or stapler surgery?

For Grade 3 piles with prolapse, both laser and stapler (MIPH/PPH) are appropriate. Here is how to decide:

Laser (LHP): Better for Grade 2-3 without significant prolapse. Precise, no cuts, minimal pain, same-day discharge, slightly longer recovery of 2-3 weeks.

Stapler (MIPH/PPH): Better for Grade 3-4 with significant mucosal prolapse. Removes excess tissue, faster procedure, same-day discharge, recurrence rate slightly lower for high-grade prolapse.

For Grade 3 with prolapse I lean towards stapler (MIPH) as it addresses the prolapse more effectively. Discuss with your surgeon what grade of prolapse you have — that is the key deciding factor.

Had Grade 3 piles treated with stapler surgery (MIPH) last year. Recovery was about 1 week. No recurrence so far at 8 months. My doctor said stapler is better for Grade 3 with prolapse which matched what the MySurgery team said.