Pristyn Care Clinic, Sector 29

Hi everyone,

I am doctor Vaibhav Kapoor. I am a consultant laparoscopic and laser surgeon at Max hospital, Gurgaon.

Today I will be discussing about new modalities in the treatment of various Anorectal conditions like piles, fissure, fistula these are one of the most common problems and with the large population you know suffering from these conditions. People generally who suffer from these conditions of Piles and fissures fistula complain of either bleeding in the rectal area which is generally fresh before or after they pass stool or they have severe pain while they pass stools and the pain generally lasts for few hours after they pass stools or they complain of some pus discharge in that region and also swelling in the anal region. So we mainly discussing the new modalities in the treatment of Piles but before that, I just give u small note on what actually these conditions are. Anorectal conditions can be classified as piles, fissure, fistula these are one of the most common things, so, what are piles? Piles are basically inflamed veins or tissues in the lower rectum and anal canal, there are various causes but the most common cause of it is chronic constipation, why does it happen lack of fibers in the food, eating junk food you know not taking a lot of water they are one of the primary causes. Then in women especially during pregnancy they can have piles, symptoms are like I told earlier are mixed these condition either patient can have fresh bleeding when they pass stools or they can have pain or some sort of the swelling in the anal region. So diagnosis is very simple the surgeon just needs to examine your lower rectum and he can come on to the diagnose it. So how do we treat it, the conventional treatment as everybody knows was open surgery for piles so it led to heavy wounds, dressing for at least a month, people not used to go out fearing that wounds will discharge. Now with the help of new technologies and with the help of laser what we are doing is the laser ablation of ambroid and fissures, it’s the diode laser and there are great advantages up over conventional surgery. It's a simple 15 to 20 minutes surgery almost painless and there were no dressings to be done in the postoperative period and patients are generally discharge on daycare. So I will be now discussing about how with the help of lasers we treat piles, so laser energy is basically delivered to the pile base marks and you know it causes instant shrinkage of the piles and then over the period of 10 to 15 days the entire pile marks should end. The advantages of using laser is it's a simple 10 to 15 minute surgery, done under either general anaesthesia or initial anaesthesia, patients are generally discharged during a daycare or they kept for maximum 24 hours, post surgery you will just your antibiotic and pain Killers that’s it, it's relatively painless surgery as compared to open, there are no wounds in the area, there no dressing to be required and even start as early as you know from next day your all routine work. Post surgery you generally gave some sort of diet chart which will help you by constipation and some pelvic floor exercises will be taught to you which will help you prevent constipation in long run. Another question which happens is that after the surgery piles generally reoccur, later with conventional surgery the chances of reoccurrence was there with the advent of laser surgery and the minimal tissue damage the chances of reoccurrence have gone down, that is one of the most advantageous things if you are with a laser.

And secondly post-surgery care which we generally don't do so that will be given to you which will help you in avoiding constipation in long run and hence these things don’t reoccur and to get any further information you can contact me through Lybrate. You will be having entire details about how the laser surgery works and you can read about piles and fissures on that.

Hi,

I am Dr. Vaibhav Kapoor. I am a consultant laparoscopic and Laser surgeon at Max Hospital Gurgaon.

Today I will be discussing about varicose veins and what are the new modalities in the treatment of varicose veins. So what are basically varicose veins, they are nothing but dilated tortuous veins over the lower leg, these veins are generally overfilling with blood. So what are the symptoms what do complete patients complaint of in varicose veins patient either complaint of dilated chord-like structure in the lower leg or they complain of pain when they stand for long or they might have itching in the lower half, some patients main complaint of skin pigmentation, in extreme cases it can lead to ulcer formation in the lower half of the leg and it can also cause bleeding. So why do they happen we need to understand the certain physiology behind it leg veins are generally anti-gravity veins they have from a lower part of the body towards the heart. So they have perforators in these which are unidirectional and which aid them taking the blood up. Now damage to these perforators leads to stasis of blood in the lower half of the vein. So these things, later on, lead to varicose veins. Now in extreme cases, we don't treat Varicose veins so what they can do they can either lead to the formation of ulcers in the lower half or patient might have started bleeding from the lower half of the body. So how do you diagnose it, Varicose veins is a clinical diagnosis one sees a surgeon and after clinical examination can confirm the diagnosis, you will take a need of ultrasound doppler which will confirm all perforator damage. Now how do you treat it in the initial studies we just tell the patient to avoid standing for long hours and to wear some compression stockings but the definitive treatment for Varicose veins is surgery. So conventionally or traditionally we have been doing open surgery which is being used to cut open at the upper part of the leg and strip the entire vein, nowadays the latest modality is laser treatment it is a pinhole surgery we generally make a small hole in a lower half of the skin on the lower leg and we enter the vein through that area, with the lasers fibre we reach to entire vein and specific amount of laser energy is delivered every cm of the vein and it is ablated. So advantages of a laser, its 10 minutes to 20 minutes surgery and it is almost painless, treatment is permanent it leads to minimal blood loss, minimal bleeding patients are able to tell out to went for the very next day and resume the normal activities in 3 days time. So we compare conventional surgery with laser surgery, so what are the advantages the conventional surgery in the conventional surgery used to tell patients to avoid walking, avoid standing for 2 to 3 months Hospital stay used to 3 to 5 days but with the help of laser surgery the surgical time is reduced to 20 to 25 minutes, patient goes home the same day, in 3 days he can start to work, the results are excellent and it's almost become painless, so these are the greatest advantages. So if you are facing these problems you can get in touch with me through my website which is drvaibhavkapoor.com at my website you will get complete information on laser treatment and on Varicose veins and proctology. If you want to visit me you can visit me at Pristyn Care, Pristyn Care is the only dedicated center in North India right now which are doing laser surgery for Varicose veins and as well as for proctology.