Proctology deals with the disturbance and disorders related to the rectum, colon, and anus. This particular medical field is also known as colorectal surgery. The term proctology is now used to refer to practices that are particularly associated with the rectum and anus.

Proctologists or the Colorectal Surgeons are those who specialize in this particular field of medicine. They are also called rectal or colon surgeons. To become a proctologist, surgeons must meet few specific requirements. It is only after completing the general surgery residency training and a fellowship in colorectal surgery in India, that the surgical doctors become eligible to receive the proper authorization and certification. The training may take 2-3 years for completion.

After undergoing advanced training and thorough education, they specialize in the surgical and medical treatment of those conditions that affects the large intestine or lower digestive tract. It is the expert proctologist that provides proper colon cancer treatment in India.

Colon Rectal Cancer

The colon rectal cancer or colorectal cancer refers to cancers or abnormal cell growth in the rectum or colon. The colorectal cancers generally begin as a growth called polyp, on the inner walls of the rectum or colon. Colorectal cancer may be benign, where the tumor doesn’t spread; or malignant, where the cancer cells begin to spread to other parts of the body.

colon rectal cancer

Stapler Hemorrhoid Surgery

The stapler hemorrhoid surgery is the latest surgical technique through which hemorrhoids in the anal area are removed or the remaining hemorrhoid tissues are sutured. A special surgical instrument called hemorrhoid stapler, which is a single application instrument, is used to perform this surgery. This surgery is basically a painless procedure and the recovery time needed is also lesser compared to other surgical techniques.

Stapled hemorrhoidopexy, also known as MIPH or minimal invasive procedure for prolapsing hemorrhoids, has transformed the treatment of 3rd or 4th degree advanced piles. In traditional piles surgery, the anal cushions are removed which can threaten a person’s control over the motions. But with the help of stapler, removal of the anal cushions can be totally avoided.

The conventional hemorrhoids surgery leaves wounds at around 3 sites, the 3, 7 and 11 o’clock positions when a patient is in delivery position or in lithotomy. These wounds take 1 to 1.5 months to heal. Throughout this phase, patients have to bear the excruciating pain, every time when stools pass. There can also be bleeding from the yet-to-heal areas and can cause gangrene or secondary infections.

However, in MIPH, the rectum’s wall is slit circumferentially; the crumpled anal cushions are pulled back in their previous position, and the raw section is sealed using the effective and advanced stapler.

Here are the main advantages of MIPH over the conventional pile’s surgeries:

Stapled hemorrhoidopexy/ MIPHConventional Piles Surgery
No wounds are there outside anusThree serious wounds at the margin of anus
Pain is almost 80% lesserWounds are painful until they heal (1 to 1.5 months)
No bleeding after or during MIPHBleeding may occur from raw wounds
Total removal of piles from the roots is possibleOnly the swollen piles are removed. The ones that are left can cause piles again in future, as the effects are only being cured, not the causes
No need to remove anal-cushions. The control over the motions stay unharmedAnal cushions are removed permanently. It becomes impossible to control the motion of the water-tight and air-tight anus
By the second day of MIPH, it is possible to get back with regular activitiesAs there are pain and chances of bleeding, rest is must at least for the next two weeks after the surgery, till the patient feel confident and comfortable to get on with his/her daily life
stapler hemorrhoid surgery

Fissure and Fistula

Anal fissure refers to a small tear or cut in the anus lining or in the anoderm. When fissure lasts more than 6 weeks, it is considered as chronic; if less than 5 or 6 weeks, then it is the acute fissure. Situated between the skin and anal canal, fistula is a tract that can cause inflammation and swellings.

fissure and fistula

Fistula-in-Ano or Anal Fistula

Fistula generally refers to a tunnel or passage that is open at its both ends. The anal fistula or fistula-in-ano is a tunnel between the anus and the skin. Here the passage has one opening on the outside of the body, around the area of anus; and the other opening on the inside of the anal canal.

fistula-in-ano-or-anal-fistula

Symptoms of Fistula-in-Ano

Severe throbbing and constant pain in the anus, accompanied by fever or chills, is the initial symptoms of fistula-in-ano. Later, when the abscess tissues or the pus bag begin to crack, then the pus starts to come out through the openings of the outer skin. As the pus from the abscess tissue releases itself on the outside of the skin, the pain vanishes and the pus pressure is relieved too. As a result, the outer opening on the outside skin begins to heal as well. But the other opening of the tunnel inside the anus remains open and starts to get contaminated.

symptoms of fistula in ano

Video Assisted Anal Fistula Treatment

The Video Assisted Anal Fistula Treatment or the V.A.A.F.T is the latest and advanced surgical technology available for treating anal fistula. In this surgical procedure, under anesthesia, a small telescopic instrument is inserted into the fistula tract through the outer opening of anal fistula on the skin. The telescope being connected to an HD camera, it displays the inner condition of the tract on the monitor. Then the total fistula tract is removed until the end of its opening on the anal canal’s wall. If there is found any branching of the tracts, it can also be treated with this surgical method. With the help of a stapler or stitches, the internal opening is then shut to prevent feces or stools leaking into the fistula passage. For removing the dead tissues from inside the ameliorating tract, saline is flushed through a syringe, as a part of the daily dressing.

video assisted anal fistula treatment

Treatment of Fistula-in ano

Treating the anal fistula is also possible without a surgery or operation. There are various conservative management techniques, as suggested by doctors, like laxatives or stool softeners that can help in treating recent or short duration or acute fissures. Sitting in lukewarm water tubs for around 10 minutes after each motion can also help to ease the spasm.

treatment of fistula in ano

Anal Fissure and Its Symptoms

Anal fissure refers to a tear, cut or ulcer in the walls of the outer border of the anus. Serious tearing, acute tearing pain when feces pass, tremendous burning sensation after each motion lasting for minutes may be hours are the main symptoms of anal fissure. Bleeding may also be there each time the stool is released.

anal fissure and its symptoms

Main Cause of Anal Fissure

When hard feces are forced out of the anus, straining or pressuring at motions, the anal opening is stretched excessively and leads to tearing or fissure. It happens at the back ends and the front of the anus (6 o’clock and 12 o’clock positions). Because the surrounding area of the anus has less blood compared to the other body parts.

main cause of anal fissure

Treatment for Anal Fissure

Scarless CLIPS or Closed Lateral Internal Partial Sphincterotomy is the latest technique for treating anal fissure. Here a sharp knife is used to bring the size of the anal opening to its normal size, as due to fissures it tends to become narrow. The lower section (about 2 cm) of sphincter muscles is cut partially for opening the anal canal. It reduces the friction of stools during the passing motions, not disturbing the healing of the anal fissure anyway. There remains no scar after performing CLIPS and it is because of this reason that it is called the ‘scarless surgery’ for anal fissures treatment.

treatment for anal fissure

B.U.S.H. – Bloodless ultrasonic scalpel haemorrhoidectomy

B.U.S.H or the Bloodless ultrasonic scalpel haemorrhoidectomy is the most advanced and superior technology for piles treatment. In this treatment, pile mass is taken out using the ultrasonic scalpel without any drop of blood.

Ultrasonic scalpel is used to cut the pile mass. It has two very thin jaws where, one of the jaws remains static and the other one vibrates at the speed of 5,500 times per second. This vibration results in friction and radiates heat energy which incises the pile mass and seals the opened blood vessels at the end of the operation. The size of wound formed in this surgery is pretty smaller than other available modes of pile operation. Moreover, B.U.S.H treatment causes very little post-operation complication and the rehabilitation time is quite low. Thus, ultrasonic scalpel instrument helps in bloodless piles surgery and faster rehabilitation.

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