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.

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.

Case Study 1 Case Study 2

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.

Piles and Anal Fissure: Awareness Is a Must!

Are you feeling pain in lower rectum and near the anus since a few days? If you see blood on your stool in addition to this pain, you might be suffering from haemorrhoids (piles) or an anal fissure. Although the symptoms may seem similar, there’s a difference between the two. While anal fissure is a tiny tear in the anus causing the formation of a linear ulcer at the boundary of the anus, piles involves swollen blood vessels near the anus, forming a protrusion to the outside.

Piles and fissure are those conditions wherein patients may have complaint of itching and bleeding. They have to suffer from a lot of pain, secretions and inability to sit down comfortably. Such lifestyle diseases affecting the anorectal health of individuals are usually intolerable. However, people take a lot of time before they finally open up before specialists about the intensity of the problem. Often traditional remedies are tried to relieve such conditions. If not diagnosed and treated in time, the ailments such as piles, fissures, and fistula may pose serious threat in the long run. Thus, it’s important to get such conditions diagnosed and initiate the possible treatments as soon as possible.

Here’s the basic information about anal fissures and piles to help you be aware of their causes, symptoms, diagnosis, treatment alternatives and preventive measures.

Common Causes
• Constipation
• Diarrhoea
• Wrong toilet habits
• Poor diet habits
• Physical inactivity
• Obesity
• Pregnancy
• Regular lifting of heavy loads
• Family history

Diagnostic Measures
• Symptomatic examination
• Rectal examination with the help of a gloved finger

Treatment Alternatives
Many people are nervous about traditional open surgery for curing a disease condition. However, surgery is not the only possible treatment for anorectal ailments. Dr. Ashwin Porwal’s Healing Hands Clinic follows a holistic line of treatment involving medication, herbal laxatives, diet & lifestyle modification, physiotherapy and Ayurveda. If none of these alternatives cures the disease effectively, surgery is the ultimate recommendation.

• For piles, HHC provides latest technology, least invasive Stapler Surgery, Laser Surgery and Laser Haemorrhoidoplasty
• For anal fissures, we offer an innovative Ayurvedic Therapy involving 5 – 6 Oil Therapy of short period of time (10 minutes for 5-7 days)

Preventive Awareness Regarding Piles and Anal Fissure
• Include whole grain breads, bran, lots of vegetables and fibrous foods in daily diet
• Snack often on fresh fruits and fruit juices
• Exercise regularly
• Avoid smoking and drinking alcohol

For more information on piles & fissure and other lifestyle diseases treatment, visit This Page. Healing Hands Clinic is a renowned piles hospital for highest quality piles, constipation, fistula, hernia, and fissure treatment.

New Method for detection of Constipation !!

Constipation occurs when bowel movements become difficult or less in frequency. Many a times it becomes tough to understand the level of the constipation hence Dr. Ashwin Porwal have come with a new technique known as MRI-Defecography test. This test shows the rectal & anal canal as they change during defecation. This test requires very less preparation and no pain also while performing this test. A jelly paste around 300 to 400ml is inserted in the anal region of the patient & the patient is asked to defecate it. All the images during the defecation process are recorded.

This test is a technologically advanced investigation is available at Fidelity Diagnostics in association with Healing Hands Clinic, located at Inamdar Hospital, Fatima Nagar under the guidance of Procto Surgeon Dr. Ashwin Porwal. To add to Dr. Porwal’s credit he is first to perform the first MRI-Defecography test in Pune, a diagnostic test for Chronic Constipation. Dr. Ashwin Porwal is founder of Healing hands Clinic, Pune which is an ISO certified Proctology Clinic.

Best Hernia Treatment Now in Pune!!

Best Hernia Treatment Now in Pune!!

A Hernia is a sac formation due to weakness or tear in abdominal muscles. A Hernia occurs when the contents of a body cavity bulge out of the area where they are normally contained. Any activity that increases intra-abdominal pressure can worsen a hernia; examples of such activities are lifting weights, coughing, or even straining to have a bowel movement, or pregnancy. We at Healing Hands Clinic believe in offering the best treatment for the ailments. One of its kind for Hernia is the 3D (3 Dimensional Mesh) Repair which not only guarantees the best results but a faster recovery as well.

Says Dr Ashwin Porwal who is one of the leading Hernia Surgeon in Pune. Dr Ashwin Porwal has operated more than 1500 successful such cases of Hernia with 3D Mesh Repair. He is also one of the famous Hernia doctors in Pune says Dr Porwal, The PROLENE 3D Patch mesh is a sterile, 3dimensional device for the repair of small abdominal wall hernias offering the benefits of tension-free hernia repair with the efficiency of 3 easy steps.

This consists of three attached components: An ‘underlay patch’ that provides for an effective posterior repair on the inside of the abdominal wall giving the benefits of Laparoscopic Repair. A ‘connector’ similar to plug, but smaller and flatter. An ‘only patch’ that fits over the abdominal wall giving the benefits of Open Mesh Repair. A device (Prolene Hernia System) has been designed to overcome many of the disadvantages of tension free hernia repair technique which is currently used primarily to repair direct and indirect inguinal hernia.

Benefits of 3D Mesh Repair

1) As the device lies flat against the abdomen, it has virtually no chance of migrating like other devices.

2) Minimal number of stitches.

3) Most important the 3-D mesh device provides the benefits of strong posterior repair like a laparoscopic procedure.

4) Guaranteed Freedom from Hernia.

5) Smaller incision (generally about 4-5cm)

6) Can be done under local Anesthesia also.

7) Discharge within 24 hours and back to work from 3rd day after surgery.

MRI Defecography a diagnostic tool for Chronic Constipation !!

MRI Defecography (scanning of evacuation) is a Magnetic Resonance Imaging (MRI) study of defecation. Defecation means the process of passing out stools from the rectum and anal canal & graphy means scanning the process. Defecography or evacuation MRI is a diagnostic test that shows the rectal & anal canal as they change during defecation (having a bowel movement). This test is used to evaluate disorders of the lower bowel that are not evident by tests such as colonoscopy or sigmoidoscopy.

Where MRI is Conducted?
The MRI scanning technique is a coordinated effort of the doctor, radiologist, trained assisting staff and the patient. This technologically advanced investigation process is available at a few places in India only. Among them in Maharashtra, it is available only at Mumbai and Pune. Only 30-45 minutes without hospitalization on OPD basis is required for the procedure.

Findings of MRI Defecography
So, MRI Defecography is a diagnostic tool in systemic approach of constipation. Positive findings in MRI will confirm you are suffering from ODS. The advanced treatment of ODS is STARR SURGERY (Stapled Trans Anal Rectal Resection).

Defecography in Pune
Healing Hands Clinic is speciality center for treatment of Defecography in Pune. At Healing Hands Clinic, state-of-the-art technology and procedures, many of which are firsts for India, cutting-edge diagnostic and surgical solutions and, most significant, the best medical minds all come together seamlessly to deliver results.

Laser Haemorrhoidoplasty: Least Invasive Treatment for Piles

No one likes to talk about Haemorrhoids but it’s one of the most common anorectal lifestyle diseases, today. Are you suffering from recurring Piles since long? You might have approached a number of doctors for a number of remedies. However, complete cure of Piles cannot be guaranteed, when they reach a severe stage – Grade IV. This blog introduces you to the latest and innovative technology Piles treatment, which is least invasive. No need to be afraid of undergoing a painful surgery anymore now!

Haemorrhoids involve blood vessels lining the anus. Excess pressure on rectal walls tends to weaken the muscles supporting the haemorrhoidal vessels. Due to pressure, the vessels swell and enlarge, resulting in a sac-like protrusion. if this protrusion is inside the rectal canal, Haemorrhoids are internal; while, if it is under the anal skin, then Haemorrhoids are external.

Treatments for haemorrhoids depend on the stage in which the patient is. Several non-surgical techniques can be used in primary two stages – Grades I and II. However, as the ailment advances to severe stage, surgical intervention has to be adopted.

At Healing Hands Clinic, a traditional treatment strategy is implemented before recommending any surgical procedure. ‘MCDPA’ stands for a combination of “Medication, Constac, Diet (modification), Physiotherapy & Ayurveda Herbal Oil therapy”. As far as surgical treatments are concerned, Dr. Ashwin Porwal, the founder of HHC, suggests two most effective, yet least invasive procedures. While one of them is Laser Haemorrhoidoplasty, the another one is STAPLER Haemorrhoidectomy.

Laser Haemorrhoidoplasty (LHP) is a minimally invasive surgery , an outpatient technique causing minimal pain and downtime. This procedure makes use of a Laser Haemorrhoidoplasty Kit enabling laser coagulation of haemorrhoidal nodes. The controlled emission of laser energy causes swollen Haemorrhoids to shrink. This technique ensures the prevention of reoccurrence of prolapse. This laser surgery does not demand insertion of any foreign material such as clamps inside the body. Haemorrhoidoplasty delivers excellent healing, since no stitches or incisions are involved. A small perianal port is used to access the haemorrhoidal tissue. Within a few hours after this surgery, the patient can resume daily activities.

Quickest & Simplest Ways to Treat Hernia

There’s nothing better than finding a reliable, harmless natural cure for an ailment, rather than having to opt for complex treatments such as surgery. Diseases such as Hernia are extremely painful and uncomfortable but couldn’t it be fantastic to find natural home remedies for such an ailment, which are the simplest to try and quickest to cure Hernia?

Yes, a number of simple and quick ways are available to treat various types of Hernia. Let us discuss some of them here in this blog.

If you are unaware of what exactly Hernia is, it’s a part of an internal body organ such as intestine or fatty tissues, protruding through weakening muscles. The weakening spots are usually across the abdominal wall surrounding the organ. The ailment – A Hernia comes along with mild pain in the beginning, which becomes severe as Hernia grows larger and severe. A Hernia patient may reach a point when the growth of Hernia is uncontrollable and the pain is unbearable. So why not try out simple natural remedies to cure the symptoms of Hernia rather than striving to cure a severe one?

According to professional Hernia doctors, natural treatments are 100% safe and effective to great extent. However, while you choose some home remedies to cure Hernia symptoms, it’s necessary to choose the proven and successfully reviewed ones for best of desired outcomes.

Milk with a pinch of turmeric powder
A herbal mixture including fennel, citrus seeds, and hawthorn & litchi seeds
Smaller meals at regular intervals
High water intake
High fibre, high protein, low fat diet
Fresh green vegetables
Whole wheat ingredients
Fresh fruits such as pineapple, avocado and fruit juices
Gentle exercise as per expert consultation
Cold compress
One spoon of licorice herb powder in a half cup of milk, once a week
A cup of ginger root tea every day, on an empty stomach
Fresh buttermilk thrice a day

At Healing Hands Clinic, the best Hernia clinic in Pune, Dr. Ashwin Porwal recommends physiotherapy, dietary modifications and medication for treating Hernia. A latest technology procedure “Mesh Repair” is recommended as the last alternative to cure severe Hernia patients.

Anal Fissure Treatment: Myth Or Reality

Are you suffering from anal fissure and now are wondering if treating the ailment is a reality or a myth? Let’s have a quick below to find the solution to this worry.

Anal Fissure (Fissure-in-ano), one of the most common anorectal diseases, which are more or less concerned to an individual’s lifestyle practices. It’s more of a vicious cycle of painful constipation causing the anal sphincter muscles to go into spasms. This, in turn, leads to more pain and spasms. This cycle ultimately makes bowel movements extremely difficult and painful, worsening constipation. The treatment for curing anal fissure aims to break the same cycle of spasms of the anal sphincter and repeated tearing of the anoderms.

When it comes to treating anal fissure, various alternatives are recommended by fissure specialists. However, the initial treatments are often effective towards softening stools and preventing constipation. At Healing Hands Clinic, the best fissure clinic in Pune, we recommend a fissure patient to include fibre-rich foods in diet and increase the water & fluid intake. Moreover, This dietary modification is also supplemented by Constac – a herbal laxative prepared exclusively at HHC.

Another treatment approach for anal fissure is Sitz bath, simply sitting in warm water to allow your sphincter muscles relax. This procedure lessens the anal sphincter muscle spasms, if practiced regularly. Surgery is the ultimate treatment alternative recommended by most of fissure doctors, when fissure reaches a chronic stage.

Dr. Ashwin Porwal‘s Healing Hands Clinic provides novel fissure treatment in Pune, in contrast to conventional interventions. We offer an innovative Ayurvedic oil therapy in 5-6 sessions, continuing for 10-15 minutes. Subjecting a fissure to this treatment for about seven successive days can be an effective treatment to cure the ailment. If none of the treatment alternatives works out to be successful, HHC recommends a painless procedure – Laser (Radiofrquency) fissure surgery.

In a nutshell, treatment for anal fissure is not a myth; in fact, a range of treatments is available but 100% cure cannot be assured by all of them.