Laser Fissure, Piles & Fistula Surgery

Proctology is the branch of medicine that deals with disorders of the anus and rectum.

In recent years, anorectal diseases have become increasingly common, often due to lifestyle changes such as poor eating habits, irregular sleep patterns, stress, and hormonal imbalances. Addressing these lifestyle factors plays a key role in improving outcomes.

A) Fissure-in-Ano

A fissure-in-ano is a small tear or crack in the skin near the anal canal, usually caused by constipation, passing hard stools, or overstretching during bowel movements. The skin in this area is very delicate, making it prone to injury.

Symptoms:

• Sharp pain during and after bowel movements
• Burning sensation during defecation
• Bleeding
• Avoidance of passing stools due to pain

Treatment:

Most acute fissures heal with conservative treatment including stool softeners and a high-fiber diet over 6–8 weeks. Chronic fissures may require surgical intervention.
Laser surgery is now preferred as it promotes faster healing, causes minimal scarring, and ensures better comfort compared to traditional methods.

B) Piles (Hemorrhoids)

Piles are swollen veins in and around the anal canal, often caused by constipation, prolonged straining, or heavy lifting. They can be internal or external and may prolapse through the anus.

Symptoms:

• Bleeding during or after bowel movements
• Mucous discharge, irritation, or itching
• Feeling of a lump near the anus
• In severe cases, permanently prolapsed piles

Treatment:

Treatment depends on the grade:

• Grade 1 & 2: Managed with lifestyle changes, sclerotherapy, or rubber band ligation
• Grade 3 & 4: Require surgical procedures like Laser Hemorrhoidoplasty or Milligan-Morgan Hemorrhoidectomy

Laser treatment is less painful, allows faster recovery, and helps patients return to normal activities quickly.

C) Fistula-in-Ano

A fistula-in-ano is an abnormal connection between the anal canal and the skin around the anus. It usually results from infections of anal glands, poor hygiene, or untreated abscesses.

Symptoms:

• Persistent or intermittent pus discharge from the perianal region
• Generally painless but often chronic in nature

Treatment:

Each case requires an individualized approach. A hybrid technique is commonly used, involving:

• Excision of the fistulous tract
• Cleaning of infected anal glands
• Curettage and laser ablation of the tract

This approach offers the best outcomes with minimal recurrence.