Concierge colorectal · UK
Laser proctology, by a consultant colorectal surgeon.
Laser haemorrhoidoplasty, FiLaC for anal fistula, SiLaC for pilonidal sinus and laser fissurotomy — day-case, sphincter-preserving, and only recommended when the evidence and your anatomy actually agree.
Why patients choose us
- 01
A consultant colorectal surgeon, in theatre
Laser proctology is a technique, not a substitute for judgement. A named ACPGBI colorectal surgeon assesses you first, then treats.
- 02
Standard alternatives kept on the table
For complex piles, high fistula or wide pilonidal disease the open standards still win. We say so before you commit to a laser.
- 03
Independent, and free
We are paid by no clinic, so the recommendation between laser and conventional surgery is impartial and costs you nothing.
Indicative pricing
What laser proctology costs privately in the UK.
Indicative ranges across our partner clinics. Send the details and we quote firm figures across two or three options.
In short
Laser haemorrhoidoplasty in our network: £2,500–£4,500, home the same day.
| Procedure | Indicative range | Typical duration | Recovery |
|---|---|---|---|
| Laser haemorrhoidoplasty (LHP) | £2,500–£4,500 | 30–45 min | Same day |
| FiLaC — fistula laser closure | £3,000–£5,000 | 30–45 min | Same day |
| SiLaC — pilonidal sinus laser closure | £2,500–£4,000 | 20–40 min | Same day |
| Laser fissurotomy (adjunct) | £1,800–£3,200 | 20–30 min | Same day |
| Combined LHP + fissure work | £3,200–£5,200 | 45–60 min | Same day |
| Colorectal consultation only | £220–£420 | 30 min | Same visit |
Prices vary by clinic, by which colorectal surgeon does the case, by anaesthetic and by whether extra work (a skin tag, a second tract) is added on the day. Laser equipment cost is real and passed through — one reason the same operation costs more than an open equivalent. We come back with a firm quote within one working day.
The problem
The right laser, the right patient, the right expectations.
Laser proctology is heavily marketed and sometimes oversold. It genuinely wins on pain and recovery — and sometimes loses on recurrence. A colorectal surgeon should say which applies to you before you sign.
-
Not sure it is right for your piles?
Grade IV, big skin tags, previous surgery — sometimes Milligan–Morgan or THD is a better answer. We say so before you book.
-
Worried about continence?
FiLaC preserves the sphincter far better than fistulotomy for a high tract. The right operation depends on where your fistula runs.
-
Want a fast recovery?
That is the honest strength of LHP and SiLaC — most people back to desk work in a week, without packing or a wide open wound.
The journey
From enquiry to recovery — what happens, in order.
One colorectal surgeon from first message to review — including the recovery window and any re-treatment.
Phase 1 · Before your procedure
Concierge, off-stage for you
Phase 2 · On the day
A few hours at the clinic
Phase 3 · After
Concierge, back on
- 01
Before
You tell us what is going on
A short, confidential form. Bleeding, lump, discharge, pain — how long, how bad, and any previous treatment.
- 02
Before
We come back with a recommendation
Within one working day: laser or conventional, which laser (LHP, FiLaC, SiLaC, fissurotomy), and an indicative price. If a laser is not right for your disease, we say so.
- 03
Before
We arrange the appointment
Usually within one to two weeks. Any blood-thinning medication is reviewed with the team and you are told exactly how to prepare, including bowel prep if needed.
- 04
On the day
Arrival at the clinic
Arrival, consent and a chat with the colorectal surgeon and anaesthetist. Almost always a short general anaesthetic or spinal for comfort.
- 05
On the day
The procedure itself
20 to 45 minutes in a proper theatre. A 1470 nm diode laser fibre is placed through a small opening — no wide wound, no packing.
- 06
On the day
Home the same day
A short recovery, written aftercare, and home within a few hours. You will need someone to collect you after a GA.
- 07
After
Recovery and review
Most people are back at desk work in three to seven days. A review is arranged at two to six weeks to check healing and confirm the tract is closed.
Typical end-to-end: 2–3 weeks from enquiry to procedure. Full tract healing: 6–12 weeks.
When it helps
When laser proctology is the right step.
The presentations that suit a laser approach — plus the one red flag that means a colonoscopy first, not a booking.
-
Grade II–III haemorrhoids
Bleeding, prolapse that reduces on its own or with a finger — the sweet spot for laser haemorrhoidoplasty.
-
Low or intersphincteric anal fistula
A tract from the bowel to the skin near the anus — FiLaC closes it from inside while protecting the sphincter.
-
Pilonidal sinus disease
A painful, discharging sinus at the top of the buttock cleft — SiLaC is a day-case alternative to wide excision.
-
Chronic anal fissure
A tear that has not healed on creams and Botox — laser fissurotomy can be used as adjunct or alternative to sphincterotomy.
-
Recurrent piles after banding
Bleeding or prolapse that keeps coming back after outpatient banding — a step up without going straight to Milligan–Morgan.
-
Wanting a shorter recovery
Office workers, parents and travellers who cannot afford a two-week Milligan–Morgan recovery.
-
Continence concerns
Previous anal surgery, obstetric injury or low resting pressures — laser preserves the sphincter better than fistulotomy.
-
Red flag: change in bowel habit
New rectal bleeding with weight loss, a change in bowel habit or anaemia is not a piles problem until proven — colonoscopy first.
Procedure options
Laser is not the only option — and sometimes not the best.
What each option on the table actually involves — laser and the standard operations it competes with.
-
Laser haemorrhoidoplasty (LHP)
A 1470 nm diode fibre is placed into each haemorrhoidal cushion. Controlled thermal energy shrinks the tissue from the inside. Less painful than Milligan–Morgan; faster back to work.
-
FiLaC — Fistula tract Laser Closure
The laser fibre is drawn back along the fistula tract, ablating it as it goes. Sphincter-preserving; NICE-supportive IPG. Best for low and intersphincteric fistulae.
-
SiLaC — Sinus Laser Closure
Same principle for a pilonidal sinus — the tract is ablated instead of excised. Day-case, small skin openings, no packing, most people walking normally within days.
-
Laser fissurotomy
Precise laser division of the fibrotic edge of a chronic anal fissure, alone or alongside a lateral internal sphincterotomy. Aims for healing without a wide open wound.
-
Combined LHP + THD
For selected patients laser haemorrhoidoplasty is combined with transanal haemorrhoidal dearterialisation — both the cushion and its arterial supply are addressed.
-
Milligan–Morgan haemorrhoidectomy
The gold-standard open operation for grade III–IV piles. More painful and slower to recover, but the lowest long-term recurrence — kept on the table where appropriate.
-
Seton or fistulotomy
For complex or high fistula, a seton or staged fistulotomy is safer than a laser. We do not pretend otherwise.
-
Consultation only
An honest colorectal assessment — including whether a colonoscopy is needed first — with no obligation to proceed to any laser.
Our vetted UK network
A small panel of colorectal surgeons, we picked them.
ACPGBI colorectal surgeons across London and the major UK cities, working in clinics with a 1470 nm diode laser and a proper day-case theatre. Not listed publicly — introductions are made privately, once we understand your case.
Selection criteria
How we choose every colorectal surgeon in our network.
-
Consultant colorectal surgeons on the ACPGBI register
-
1470 nm diode laser platforms with radial fibres for LHP and FiLaC
-
Day-case theatre with anaesthetist and 23-hour recovery on standby
-
Willingness to recommend conventional surgery when it is the safer answer
Safety and recovery
What to expect afterwards — honestly.
Laser proctology is a genuinely lower-pain, faster-recovery option for the right patient. It is not a magic wand — recurrence and continence deserve an honest conversation.
-
Less post-op pain than Milligan–Morgan
The commonest reason patients pick laser. Most manage on paracetamol and a short course of a mild opiate, not weeks of strong painkillers.
-
Some bleeding is normal
Spotting for a few days is expected. A brisker bleed at five to ten days, when the coagulated tissue separates, happens in a small minority — call the team.
-
Recurrence is real, and honest
LHP recurrence around 10–20% at 12 months, FiLaC 30–40%, SiLaC 15–30%. Higher than open standards for the same disease — the trade-off is pain and recovery.
-
Continence is protected — not guaranteed
FiLaC incontinence risk 1–3%, well below fistulotomy for a high tract (5–15%). Any previous obstetric or anal surgery is factored in beforehand.
-
Bowel motions from day one
Softeners, fibre and plenty of water. Straining is the enemy of every anorectal wound, laser or otherwise.
-
Return to work in days, not weeks
Desk work in three to seven days. Manual work and cycling wait two weeks. Sports at two to four weeks.
-
Evidence base is growing, not settled
Laser proctology has good UK adoption in the private sector and NICE support for FiLaC, but long-term UK trials against gold-standard surgery are still maturing.
-
Not for everyone
Grade IV piles, complex high fistula and extensive pilonidal disease still do better with the classic operations. A laser is not a magic wand.
-
Red flags
Fever, uncontrolled bleeding, inability to pass urine, spreading redness or worsening pain after 48 hours are not normal — call the clinic or A&E the same day.
Reading your operation note
Your operation note in four parts. Read the last one first.
Whichever laser technique was used, the note the colorectal surgeon sends you keeps to the same shape.
A quiet reminder
Surgical language is precise and can read coldly — we translate it for you.
If you would like us to talk you through the note before your review, just ask.
- 01 Header
Indication and procedure chosen
Why the procedure was done — piles, fistula, pilonidal, fissure — and which laser technique was used (LHP, FiLaC, SiLaC, fissurotomy).
- 02 Technique
Laser settings and anatomy treated
The wavelength (usually 1470 nm), energy delivered per cushion or per centimetre of tract, and which cushions, tracts or sinuses were treated.
- 03 Findings
Any additional pathology found
Notes on other findings under anaesthetic — a skin tag, a second fistula tract, a fissure — and whether they were addressed at the same sitting.
- 04 Impression
Recovery, review and re-treatment plan
Read this first: expected recovery, when to return to work, when a review is booked, and the honest chance of needing a repeat or a conversion to open surgery.
Recognised by major UK insurers
Cover for laser proctology varies by insurer and by procedure — FiLaC and LHP are funded for many indications, others may be self-pay. We confirm cover before booking.
Frequently asked
Everything we get asked about laser proctology.
Quick answers on pain, recurrence, cost, and how it compares to Milligan–Morgan, fistulotomy and open pilonidal surgery.
-
What is laser proctology?
An umbrella term for laser treatments of anorectal conditions — laser haemorrhoidoplasty (LHP) for piles, FiLaC for anal fistula, SiLaC for pilonidal sinus, and laser fissurotomy for chronic anal fissure. A 1470 nm diode laser is used to ablate or shrink tissue through small openings, instead of a wide excision.
-
Is laser haemorrhoidoplasty better than a Milligan–Morgan?
For grade II–III piles most patients find LHP much less painful and are back to desk work in a few days rather than two weeks. The trade-off is a higher chance of recurrence at 12 months (about 10–20%). For grade IV or heavily prolapsed piles Milligan–Morgan is still the gold standard.
-
Does FiLaC actually work for anal fistula?
Yes, for the right fistula. Published series show around 60–70% success at 12 months for low and intersphincteric fistulae. NICE has issued a supportive interventional procedures guidance. Complex or high fistulae are still safer with a seton or staged approach.
-
What are the real risks of laser proctology?
Bleeding (usually minor, occasionally a brisker bleed at 5–10 days), infection, urinary retention, recurrence, incomplete tract closure, thermal injury to the sphincter, and — rarely — anal stenosis. Incontinence risk with FiLaC is around 1–3%, well below classic fistulotomy for a high tract.
-
How much does laser proctology cost privately in the UK?
Roughly £2,500–£4,500 for laser haemorrhoidoplasty, £3,000–£5,000 for FiLaC, and £2,500–£4,000 for SiLaC. Laser fissurotomy alone sits at £1,800–£3,200. Combined procedures cost more. We confirm a firm figure within one working day.
-
Is laser proctology available on the NHS?
Provision is variable. A handful of NHS trusts offer FiLaC and SiLaC as part of a colorectal service, and some offer LHP. Most people who want laser proctology in the UK access it privately, and we help you compare cover with your insurer where relevant.
-
How long is the recovery after LHP or FiLaC?
Most people are back to desk work in three to seven days and to normal activity within two weeks. Full healing of a fistula or pilonidal sinus takes six to twelve weeks. There is no wide open wound to dress, and no packing.
-
When should I see a GP or A&E urgently?
New rectal bleeding with weight loss, a change in bowel habit or anaemia needs a colonoscopy before any laser — piles and cancer can coexist. After surgery, fever, uncontrolled bleeding, inability to pass urine or worsening pain after 48 hours are all reasons to seek same-day medical help.
Related treatments
Looking for something else?
Nearby in the library