Dr. Rohit Kumar, along with his team also conducts minimal invasive surgery for proctology diseases.
Common causes of hemorrhoids are obesity, chronic constipation, prolonged sitting, diet, diarrhea and pregnancy. Hemorrhoids (swollen veins in the rectum and anal area) that are hidden inside the rectum are called internal whereas the ones you can see and feel are called external hemorrhoids.
If the hemorrhoids become bothersome then minimal invasive surgery is the best option.
- Rubber band ligation is a the widely used procedure, it is successful in approximately 70 to 80 percent of patients. Rubber bands are placed around the base of an internal hemorrhoid. As the blood supply is restricted, the hemorrhoid shrinks and degenerates over several days. Patients are encouraged to use fiber supplements to avoid constipation.
- Laser, infrared, or bipolar coagulation method involves the use of laser or infrared light to destroy internal hemorrhoids.
- Sclerotherapy - a chemical solution is injected into hemorrhoidal tissue, causing the tissue to break down and form a scar.
- Stappler Hemarrhoidopexy (MIPH)
- THD (Transanal Hemorrhoid Deasterialization)
A tear in the skin lining of the anus or the anal canal that results in bleeding and pain is a Fissure. Fissures can develop into further problems if not cared for and treated properly.
The treatment plan for Fissure may vary. Most anal fissures do not require surgery and treatments may include:
a. Laser Sphincterolisis
b. Lateral Internal Sphincterotomy
- Warm sitz baths several times a day
- dministration of stool softeners and fluids to relieve constipation
C. Fistula of ANO
Anal fistula is an infected tunnel connecting the skin on the buttock to an internal part of the anus. This fistula usually forms as a result of an inflammation of one of the glands in the anus.
Surgery is the only method to treat an anal fistula. Antibiotics will help control the infection but the infection will recur as long as the tunnel or tract is left open. Fistula surgery is done as an outpatient procedure but very deep fistulas may require a short hospital stay.
Following techniques are used for a Fistula Surgery:
- Ligation of the Intersphincteric Tract Surgery (LIFT)
- Advancement rectal flap
- Muscle flap
- Laser Fistulectomy
D. Rectal Abscess
Rectal Abscess arises from an infection at one of the anal sinuses which leads to inflammation and abscess formation. Most cases of perianal abscesses are sporadic, and may aggravate due to diseases like, diabetes mellitus, Crohn’s disease, chronic steroid treatment and others.
Anal abscesses can be treated by a simple course of antibiotics in early stages if delayed surgery will be required to remove the abscess. Treatment is possible in an emergency room, but it is highly preferred to be formally admitted to a hospital and have the surgery performed in an operating room under general anesthesia.
The procedure includes a small but deep incision close to the root of the abscess. The surgeon will allow the abscess to drain its exudates and attempt to discover any other related lesions in the area. This is one of the most basic types of surgery, and is usually performed in less than thirty minutes by the anal surgical team.
If the rectal abscess is not treated properly and in time it may lead to Fistula in ANO (Anal Fistula).
E. Rectal Prolapse Surgery
Rectal Prolapse occurs when a part of the rectum (last part of the large intestine where fecal matter is stored) projects out of the anus. It becomes noticeable over a period of time and is often the result of weak muscles in the pelvis. There are three types of rectal prolapse namely full thickness (full wall of the rectum sticks out), mucosal (lining of the anus known as mucosa come out), and internal (the rectum folds in but does not stick out).
There two general types of surgery for rectal prolapse are:
Abdominal: A cut or several cuts are made through the in the abdominal wall. Often used for full-thickness prolapse.
Perineal: Involves cutting out the full thickness segment of the prolapsing rectum. Suitable for people who cannot have a general anesthetic.
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