Painless Laser Piles and fistula surgery.

Conventional piles surgery consists of ligation of the veins causing piles at the top of anal canal. This involves a lot of cutting and exposure to the anal sphincter. This results in the following
1. Spasm of Anal sphincter >> This causes the post operative pain faced by patients. It can extend to 2 months for some patients.
2. Damage to Anal sphincter >> This causes shrinking of anal opening in most cases. Once this develops the patient will have a lifelong need for laxatives to form loose stools.
In our experience this complication is as high as 20% of operated cases. It is more in 3rd degree piles.
3. Sometimes the damage can cause non-functioning of Anal sphincter  and the patient can loose control over his/her motions.

Above complications happen in best of surgeons hands and therefore anyone is prone to develop them.

Painless piles and fistula by laser  follow the following principles
   1. The Anal Sphincter is not touched or exposed.
   2. No cutting of tissues at the Anal canal.
   3. The primary cause of constipation is tackled by modifications in diet.
   4. There should be no need of drugs beyond 3 weeks.
 

                                                Laser Ablation of Piles and fistula

Laser has revolutionized medicine in many ways. Laser allows the surgeon to be fast as well as precise in surgery. Minimal trauma and fast recovery are hallmarks of laser medicine. Laser minimizes body reaction ensuring a fast and painless recovery in most cases. Laser ablation of piles allows the doctor to precisely focus attention to veins forming piles leaving all surrounding tissue intact, including the lining over the piles.

Minimal tissue handling allows the patient to have an excellent recovery from pain and constipation and bleeding in a very short time.

 Q. What is the cause of pain after non laser operation.?

A. Pain is caused by cutting of tissues around piles.

 Q What causes recurrence of Piles?

A Recurrence is caused due to non-relief of original constipation as well as narrowing of anal canal after surgery called Partial Anal Stenosis.

This condition actually leads to patient becoming life long dependent on laxatives to pass motions.

This problem is negligible in Laser Ablation of piles due to excellent relief of constipation and no possibility of Partial Anal Stenosis.

 Q. Is there dietary restriction after Laser Ablation of piles?

A. Good dietary habits are always better in long run., but there is no specific dietary restriction after Laser Ablation of Piles. All patients can go to the diet of their choice as long as there is no problem with their medical conditions if any.

 Given below is an approximate comparison between Conventional Surgery and Laser Ablation of piles/fistula

	Conventional surgery	Laser Ablation of Piles/fistula
Post op pain	2-4 weeks (major)	1-2 days(minor)
Time of Surgery	30-45 mins	5 mins
Bleeding	++	Nil
Constipation relief	+	++++
Join work	2-4 weeks	2 – 4 days
Post op anal bath	3-4 weeks	Nil
Anal canal narrowing	30-50% cases	Nil
Dietary restriction	Non veg/spices	Practically negligible
Post op medication	2-4 weeks	2 days
Low Hb	Not possible without blood	Possible
Recurrence	30-50% cases	Negligible if no constipation
Laser fistula ablation after surgery
At presentation multiple fistulas	Week 2 after opn
Week 3 after opn	Week 5 All healed