Dr. Vivek Bindal is the Best Laser Piles Surgeon in North India – WHAT IS A LASER ? Laser is a high-energy light that is used to safely cut or burn the affected tissue during surgical procedures. WHAT IS LASER PROCTOLOGY? Laser proctology refers to the treatment of diseases of the colon, anus, and rectum via laser application.
Laser surgery or laser therapy is a day-care procedure that offers several advantages over traditional surgery. Compared to banding surgery, laser effectively treats hemorrhoids, improves symptoms, and reduces post-operative pain. Similar benefits are seen for patients with severe anal spasms, external thrombosis, fissure, and sentinel tags, fistula & varicose veins due to ever-growing advantages, namely:
Laser hemorrhoidectomy is a technique in which the surgeon burns to shrink the swollen hemorrhoids. Alternatively, the surgeon may use a narrow beam of the laser to focus only on the hemorrhoid and not damage the nearby tissues. It is a safe procedure with minimal bleeding and a quick healing time.
A laser fiber is passed through the anal opening and laser energy is applied to the haemorrhoidal mass. The controlled emission of laser energy reaches the submucosa zone, causing the haemorrhoidal mass to shrink. Fibrosis reconstruction generates new connective tissue, ensuring the mucosa adheres to the underlying tissue preventing the recurrence of prolapse
Fistula laser closure (FiLaC) is a novel sphincter-saving procedure for the treatment of anal fistula. Primary closure of the track is achieved using laser energy emitted by a radial fiber connected to a diode laser. The energy causes shrinkage of the tissue around the radial fiber with the aim of closure of the track
For anal fissure that is resistant to medical and conservative approaches, a surgery called as lateral internal sphincterotomy (LIS) is performed. During the surgery, a small portion of the sphincter muscle is removed. This helps to reduce pain and pressure and allows the healing of the fissure.
There is no restriction of physical activities post laser surgery, you are allowed to walk as soon u recover from anesthesia, the patient is allowed to go to the toilet on their own. There is no restriction on climbing stairs, you may even drive two-wheelers or cars as soon as you feel fit.
The patient can return to normal activities / join back work within 1-2 days after the laser surgery.
The patient is encouraged to adopt a healthy lifestyle with a healthy fiber-rich diet
Laser surgery is safe with lots of benefits, as such there is no disadvantage of laser surgery
As per literature, there is a 5-7 % chance of recurrence of perianal disease after laser surgery
36 year old male patient presented with acute pain and puss discharge peri-anal region. He was examined, investigated and found to have complex perianal fistula. In these challenging complex fistulas with sphincter involvement and high fistulas; VAAFT is procedure of choice as in these complex fistulas require sphincter saving surgery to avoid cutting of sphincter and faecal incontinence. VAAFT is minimally invasive and sphincter-saving technique for complex high fistulas. The technique is based on direct endoluminal vision; giving the advantage to identify missed fistulas tract and high internal opening. Internal opening is closed through anal route and whole of the tract is destroyed under direct vision using electrode. Procedure is of advantage of having very small post-operative wound, next day discharge and least post-operative pain. In this patient under spinal anaesthesia fistuloscopy was done. Multiple fistulas tracts were identified along with internal opening. Internal opening is closed and tracts were cauterized using electrode. Postoperative next day patient was discharged with very less pain and no major dressing. Why vaaft is better than standard fistulectomy in complex high peri-anal fistula??? Perianal fistulas can present with single or multiple tracts. Tracts can be intersphinteric, transsphinteric, suprasphinteric or extra sphinteric. VAAFT is procedure of choice in high complex anal fistulas giving the advantage to identify missed fistulas tract and high internal opening. Internal opening is properly identified and whole of tract is cauterized; preserving the sphincter. Whereas performing standard fistulectomy in complex high transsphinteric fistulas includes cutting of sphincter and resulting in large wound with fecal incontinence, increasing the morbidity of patient.
Less than three bowel movements a week is, technically, the definition of constipation. However, how often you “go” varies widely from person to person. Some people have bowel movements several times a day while others have them only one to two times a week. Whatever your bowel movement pattern is, it’s unique and normal for you – as long as you don’t stray too far from your pattern.
Other key features that usually define constipation include:
The findings suggest that 22% of the adult Indian population is suffering from the condition, with 13% complaining of severe constipation. 6% of the Indian population suffer from constipation associated with certain comorbidities.
Certain people are more likely to become constipated, including2
Complications of chronic constipation include:
The following can help you avoid developing chronic constipation.
Several types of laxatives exist. Each works somewhat differently to make it easier to have a bowel movement. The following are available over the counter:
If over-the-counter medications don’t help your chronic constipation, your doctor may recommend a prescription medication, especially if you have irritable bowel syndrome.
Biofeedback training involves working with a therapist who uses devices to help you learn to relax and tighten the muscles in your pelvis. Relaxing your pelvic floor muscles at the right time during defecation can help you pass stool more easily.
During a biofeedback session, a special tube (catheter) to measure muscle tension is inserted into your rectum. The therapist guides you through exercises to alternately relax and tighten your pelvic muscles. A machine will gauge your muscle tension and use sounds or lights to help you understand when you’ve relaxed your muscles.
Surgery may be an option if you have tried other treatments and your chronic constipation is caused by a blockage, rectocele or stricture. For people who have tried other treatments without success and who have abnormally slow movement of stool through the colon, surgical removal of part of the colon may be an option. Surgery to remove the entire colon is rarely necessary.
MS, MRCS (Glasg), DNB, MNAMS, FNB