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Painless Proctology A new dimension in proctology care Dr Rusy Bhalla M.S. Current proctology Piles Fistula Piles A curse! Is the treatment worse? Formation of Piles Piles Causes Of Painful Proctology Current Piles management Cutting of tissues at anal canal Exposing of Anal sphincter Blood loss Use of cautery Normal Piles Surgery appearence Complications of Routine Piles Surgery Pain for 3-4 weeks Intra op Bleeding Constipation increased due to anal spasm Partial Anal stenosis after 1 year Result of Routine Piles surgery Complications of Partial Anal Stenosis Life long medication to pass motions Straining at passing motions causes bleeding Interpreted as return of piles Abdominal pain due to constipation Painless Laser Piles Surgery No Post operative pain No Intra op bleeding No Post operative complications No Recurrence No Anal stenosis No Constipation No medications OPD Procedure Routine fistulectomy Fistula opening Causes of painful Fistulectomy Routine Post Fistulectomy Surgery Post Operative Fistulectomy Intense pain for 3-4 weeks No sitting for 4 weeks Healing takes 2 months Partial Anal stenosis in more than 50% cases No relief of constipation Partial Anal stenosis Development Painless Fistulectomy Painless Fistulectomy Minimal pain for 2 days Patient sitting on 2nd day Day care surgery No danger of Anal stenosis No danger of Anal Incontinence Total relief of constipation No medication beyond 1 week Painless Proctology Ideal answer to problems of proctology Huge benefit to patients 30% of General surgery practice Concept Marketing required Huge returns No centre in Mumbai practicing it First mover advantage