A Novel Combination of Fistulectomy & Leonardo Laser Therapy to Cure Complex Recto-inguinal Fistula

This is a story of a long (4-5 years) suffering from fistula, of a 31 years old male patient. It started with fever and severe abdominal pain. While working at the Central Industrial Security Force (CSIF), he had a very stressful schedule with a lot of traveling all through work hours. Being a workaholic by heart, health took a back seat in his life.

The pain & fever were neglected with mere medications for a few weeks, which later aggravated in a few years and led to internal pus formation in the abdomen. Initially, the patient had no complaints such as swelling at the rectum. However, due to consistent sitting in one place & pus accumulation, he gradually started facing discomfort, bleeding stools and extreme pain. At this time, he consulted a local surgeon for immediate attention & cure. He was advised to do an Ultrasonography of abdomen & pelvis that showed pus collection in the right side of the abdomen. Later, he underwent a surgery for the same.

For a few weeks, he was totally relieved from the problem but after two months, the same symptoms began to re-occur. He got operated thrice for the drainage of pus, since the problem was seen to be recurrent every time.

Until then, the symptoms related to the rectum persisted. He was very frustrated, as his daily routine was getting hampered a lot. Later again, he was detected with pus collection in the abdomen; this time in the left side. He was frustrated enough with the ailment by the time and decided to seek a second opinion from a popular and expert surgeon in the city.

A surgeon advised him to undergo an MRI Fistulogram, which showed a big fistulous tract from the left inguinal region to the rectum (medically known as recto-inguinal fistula). He was operated for the draining pus and was addressed with a colostomy bag. This was certainly, the final hope for the patient but to his surprise, the problem re-occurred again! Stool was diverted from the abdomen. At this point, his condition was near to worst. It was like bearing the pain to live with the colostomy bag.

He was further referred to Fistula Specialist Dr. Ashwin Porwal, a renowned Colorectal Surgeon & Founder of Healing Hands Clinic and HOD of Proctology Clinic at Apollo Jehangir Hospital, which is a specialty centre for all anorectal ailments. He was further diagnosed of Complex Recto-inguinal Fistula. The findings showed that he had a fistula track that was formed from the left inguinal region (left lateral wall of pelvis) to the rectum. One opening was at the left lateral wall of pelvis and another at 6 o’clock of anus.

As the fistula had a long pathway (25 cm), Fistulectomy wasn’t possible. Thus, from the inguinal region, 7-8 cm fistulous tract was taken out and partial closure of the tract was performed. Again a 3-4 cm fistulous tract from the anal region was extracted (fistulectomy) and a total closure was performed with the help of the latest device Leonardo Laser, introduced recently by Dr. Ashwin Porwal for the first time in India. A very small opening was intentionally left open from the inguinal region & resultant wound was not completely closed, to let it heal on its own.

This patient was hospitalized for 3 days, was on IV Antibiotics. Post discharge he was advised a follow up of once in 2 weeks, for 2 months. A course of antibiotics & anti-inflammatory & antacid medications was prescribed for a month. Commenting on the aftercare follow up of the patient, he’s absolutely stable performing his normal routine at home. He has taken leave from work to recover completely.

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Re-Current Pilonidal Sinus through Leo-Nardo Laser

This is a story of a 23year old female patient suffering from Pilonidal sinus. The patient was suffering from ailment sinus 2year. It started with formation of boil along with pus discharge and pain over sacral region. Being a student she had a very stressful schedule, so she started ignoring it.

As the symptoms aggravated, the patient approached a surgeon in Nanded where she was advised a fistulogram; thereby underwent a vy surgery for Pilonidal sinus. After the surgery, the patient was completely relieved from the symptoms, but after 1 year the same complaints started occurring. The patient developed a boil over the sacral region with occasional pus discharge. Pain and other symptoms were neglected by medication. However, the ailment was creating a hindrance in daily routine of the patient. This frustrated the patient a lot and forced her to go for a second opinion.

She came to know about HHC through just dial and came for consultation. She was examined by Dr.Ashwin Porwal, Colorectal Surgeon & Founder of HHC, where she was diagnosed of having pilonidal sinus on clinical examination. As it was a re-current pilonidal sinus, she was advised laser-excision of the sinus. The surgery was performed in afternoon with the help of latest device Leo-Nardo laser introduced recently by Dr. Ashwin Porwal for the first time in India. The resultant wound was left open to undergo natural healing. The patient was discharged in the evening. Post discharge, she was advised follow-up once a day in a week for 2 months so as to clean the wound and to ensure natural healing process. A course of antibiotics, analgesics and antacids is prescribed for 14 days. Commenting on the aftercare follow-up of the patient she is absolutely stable performing her normal routine.

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Severe Anal Spasm Cured without Surgery

This is a story of an 18 years old female patient. She had a complaint of pain and burning during bowel movements since 2-3 months. Initially till two months, she neglected this symptom but later, the pain during bowel movements started to increase day-by-day. Being too young to share such kind of problems with her family members or friend circle, she was wondering how to get rid of this condition. One day, while reading newspaper, she came to know about Healing Hands Clinic, Pune. She immediately planned to visit the clinic for curing the extreme pain while bowel movements.

Dr. Ashwin Porwal (Consultant Procto Surgeon) & the founder of Healing Hands Clinic, Pune diagnosed the patient to have Severe Anal Spasm along with skin tag. The patient was afraid of undergoing a painful surgery; thus, Dr. Porwal advised her to follow the MCDPA (Medication, Constac, Diet, Physiotherapy, Ayurvedic Therapy) course, an innovative line of treatment implemented only at Healing hands Clinic. This course included medication for one month, a diet session alonmg with physiotherapy and six alternate sessions of Ayurvedic oil therapy. Constac is an advanced, herbal and non- habit forming stool softener. It not only relieves the problem of hard stools but also effectively relieves one from gas, acidity and other digestive ailments.

As soon as the patient underwent the first oil therapy session, she had relief from about 70%-75% of previous pain and she decided to continue the therapy. After completing our MCDPA course for one complete month, the patient is now totally free from pain and no hard stools complaints as well.

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