Proctology

ANAL FISSURE TREATMENT

Anal fissures are the second most common (after hemorrhoids) cause of need to have an appointment with a proctologist. Anal fissures are manifested by severe pain in the anus after defecation and small discharge of blood. If the patient is not examined by a specialist in time (in the first 1-2 weeks) and the correct method of treatment is not chosen, a fissure becomes chronic, its edges become rough like a scar, and it can no longer heal by itself. The only choice in such cases is a surgical treatment.

In the "Dobrobut" proctology center anal fissures are surgically treated using Surgitron – the special radiowave device. Rough edges of a fissure are removed using radiofrequency current, and after that it can heal totally and painlessly. If necessary, lateral sphincterotomy can be also performed. A small, 2-3 mm incision is made on the muscle of the internal sphincter in order to eliminate the painful spasm of the wound. The postoperative period is almost painless, painkillers needed only for 1-3 days. Operations can be performed using either general or local anesthesia. In order to provide our patients with maximal comfort and safety, we recommend hospitalization within 12-24 hours. In 2 hours after the surgery you can get up and walk, eat, and after 3-4 days – return to a normal life.

PARAPROCTITIS AND RECTUM FISTULAS. RECTOVAGINAL FISTULA

For many years we are deliberately concentrating patients with acute and chronic paraproctitis from different regions of our country and from abroad, including especially difficult cases and relapses after multiple unsuccessful operations. So that we have now an experience of more than 800 operations of rectal fistulas.

Paraproctitis is a purulent inflammation of the soft tissue around the rectum. In most cases, such an abscess is strongly connected with the lumen of the intestine, which is called fistula. Eliminating abscess and fistula is a complicated surgical challenge that requires the participation of doctors of different specialties.

Using modern diagnostic and surgical equipment, we treat patients with paraproctitis in Kyiv according to German and US standards.

For high-precision diagnostics we use magnetic resonance imaging with the Toshiba 1.5 Tesla. MRI in complex rectal fistulas makes possible to recreate all the anatomical relations, and every move of the surgeon’s hand during the operation is performed like he has a map. The method of operation is chosen individually for each patient:

Radio wave surgery Surgitron

removing a fistula using the RF current. After that there remains a petal-shaped wound. Its vertex is located in the rectum, its basis – on the skin. Such wound heals by itself within 1-1,5 months. This method provides the best results - no less than 92% cases of successful healing. The pain in the postoperative period minimizes through the using of radioknife. The hospital treatment takes 1-2 days and rehabilitation is performed using the program Fast Track.

FILAC - laser photocoagulation of fistula

performed by us for the first time in Ukraine. This method uses the latest generation of laser Biolitec 1470 nm. The laser light guide is injected into the fistula channel and "brews" it from inside without damaging of surrounding tissue. Method is less-traumatic, there is no need to take painkillers after the operation – it can be performed even on an outpatient basis. Currently, this method is recommended for not too complicated cases of fistula.

LIFT - microsurgical removal of a fistula

without damaging of the sphincter muscles, performed by our specialists for the first time in Ukraine in 2010. Through a small incision (less than 1-2 cm) near the anus using a special tool the fistula is picked out at the very beginning, near the rectal wall. In this area the fistula is stitched and severed, and so that the connection between fistula and rectum is broken. During the procedure there is no risk of damage to the sphincter muscles and the incontinence. Healing occurs quickly and painlessly. The patients spend in hospital no more than 1 day. The method is particularly indicated for complex fistulas.

VAAFT – video-assisted anal fistula treatment without an incision

in Ukraine, a method is exclusively available only in "Dobrobut" proctology center. For the operations the unique equipment Karl Storz (Germany) is used; it is an endoscope with a diameter less than 4 mm. Under video control the device is injected directly into the fistula, its walls are removed from inside, without damaging the skin, mucosa, and sphincter muscles. After the operation the inner hole of rectum is closed with a suture. In 1-2 hours after the procedure, the patients can become active and leave the clinic the next day. This method makes possible to eliminate even the most complex fistulas with the residual cavities.

The advantages we offer:

• Accurate and painless examination and treatment using modern equipment
• Individual treatment programs designed according to European and US standards
• Treatment of proctological diseases of any complexity
• A full-featured multi-hospital and a team of physicians of all specialties
• Modern anesthesiology - the best pain management strategy for each patient
• Accelerated rehabilitation program Fast Track
• Physicians with the experience of several thousand operations and abroad internships