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Laparoscopic, Robotic and LASER Surgery - GI & Colorectal, Navi Mumbai


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    All Posts Tagged: Colorectal Surgeon

    Effectiveness of Neurotoxin

    Effectiveness of Neurotoxin-Botox Injection for Anal Fissure

    Anal fissure is a common condition which occurs due to the increased pressure in the internal anal sphincter located in the anal canal. Being this condition could affect all age groups, especially young adults and the main presenting complaints include pain in the anal area on defecation and bleeding per anus.

    Acute anal fissures are usually treated conservatively either with life-style modifications like increased dietary fiber and water intake or using over the counter medications like stool-softening agents (Laxatives). Some Patients are also advised to use Sitz baths, local anesthetic ointments and Glyceryl trinitrate which will ease the pain on defecation and eventually heal the fissure completely.

    Chronic anal fissures, do not respond to this kind of treatments and may require surgical interventions.

    Botox injection (a neurotoxin) is a latest yet, very safe and efficient method of treatment used in patients with anal fissures and commonest indication for the procedure includes chronic idiopathic anal fissure uncomplicated by other anal conditions. It is also known to be involved with a very simple technique which can be carried out in the outpatient department (OPD), without the requirement of sedation or local anesthesia.

    How botox Injection works on anal fissure?

    An elevated resting pressure in the anal sphincter muscles due to their hyper-tonicity (increased tone) is known to be the major cause for anal fissures to develop. This will result in a disruption of blood supply to the anal mucosa, since the blood vessels which are responsible in distributing blood to the distal anal canal are being pressurized by the increased tone of sphincter muscles, creating a chronic anal fissure.

    Botox injection which contains a neurotoxin, will paralyze the internal anal sphincter on a temporarily basis and thereby decrease its tone and spasms which obstruct the blood supply to the distal anal canal. With proper perfusion and nourishment, the fissure will heal over time and symptoms will disappear. The effect of the toxin will last for about two to three months, which is usually enough for an uncomplicated fissure to resolve.

    This method can be expensive yet, cost effective since it will lead to complete healing of the fissure without having to go through the risk of bowel incontinence, complications of anesthesia and wound infections which may occur as a result of lateral internal sphincterotomy surgery. More importantly, the technique used and the site of injection are independent of patient’s age, gender and the location of internal sphincter ring.

    Although, there are no major side effects of Botox injections, some patients may complain of minor reversible bowel leakage (incontinence), inability to control passage of air (gas incontinence), pain caused by the injection, bleeding or hematoma formation and infections at the site of injection.

    Regular follow-ups are encouraged to see the response to the treatment and improvement of symptoms and patients who do not show any positive results even about eight weeks following the Botox injection or experience complicated fissures creating severe symptoms, will have to consult colorectal surgeon or surgical gastroenterologist and undergo a surgery.

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    Doctor nitesh return from germany

    Dr. Nitish returns from Germany after training in VAAFT for fistula

    Dr. Nitish Jhawar General, Laparoscopic and Colorectal Surgeon at Fortis Hiranandani Hospital, Navi Mumbai, India recently attended a surgical workshop at Berlin (Germany )to understand and perform VAAFT – Video Assisted Anal Fistula Technique- better. This endoscopic treatment of fistula doesn’t have a risk of incontinence.

    In today’s era of minimally invasive surgeries, emphasis on painless treatment and faster recovery without much dissection of the tissue is higher. Anal fistulas have been treated from the era of Hippocrates from 1600 DC. Everything starting from horse’s hair to laser has been tried to treat these nagging problem. The two main factors / fear in fistula surgery is recurrence and incontinence due to incomplete removal or excessive cutting of sphincter.

    There are various surgical ways to treat fistula including removal of the fistula track completely. This is surely painful, requires daily dressing and also takes a lot of time to heal. Along with which there are higher chances of recurrence; whereas, VAAFT requires no incision, which helps patients to resume their daily lives with ease.

    This endoscopic treatment offers a complete diagnosis of the fistulous tract in the form of fistuloscopy and since no cutting of the sphincter is involved, there is no risk of incontinence. The latest case studies are showing encouraging results in this particular modality. Tackling recurrence of the fistula with VAAFT is much easier option and  acceptable to the patient because of its painless patient-friendly treatment.

    On his visit to Berlin, Dr. Nitish Jhawar met Dr. Monreio, who is the inventor of this technique and have more than 10 centres all over the world.

    Dr. Monreio takes pride in the efficacy of this treatment which is helping him treat patients all across the Globe. As per Dr. Jhawar –“ It was a wonderful experience to learn the Nitti gritty of the surgical challenges and their management from the inventor himself. VAAFT has clearly achieved a reputed place in ARMAMENTARIUM of fistula treatment modalities and is here to stay. I am aiming to continue his legacy of helping people with VAAFT and make it easier for the patients suffering from Anal Fistula.”

     

    doctor nitesh germany trainingdoctor nitesh germany training session

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    Testimonial

    What patient says about Dr. Nitish Jhawar

    • Person Image

      I was diagnosed with gall stones a year ago in Delhi, I showed it to a doctor at Max hospital, he just asked me to get a surgery done and get my gall removed on any date of my choice, I was sacred and too young to get it done I got a vibe from doctor that for him it’s just a small things, however according to for a patient it’s important first be convinced on the urgency to get it done and feel safe . A year later I shifted to Mumbai and started having a frequent pain in shoulder blades and gall area. It went sharp this time. We went to Dr Nitish , as oppose to Delhi doc, Dr Nitish was very polite, first asked us to get the scan done and understand the current scenario, the scan showed one big 17 mm stone which was earlier also there but this time also there were multiple various sized stones as well along with the big one. Dr Nitish examined the scan, explained me and my husband about the condition and need of surgery or else the stone Would have slipped in the panacea or bile calling for a bigger operation. He explained diagramatically . He was patient in explaining, gave us time to think and be convinced. We were ready and then he performed it . It was flawless, quick and went well. He is a very experienced and fine surgeon , he is caring and doesn’t create panic at all rather he takes it slowly and makes patient comfortable. It was lapro, it’s been 2 months I m writing this . I faced no issues till now. Apollo staff was also very caring and good. I would mention Apollo Hospital, Navi Mumbai in specific. Good follow up diet makes it normal. I would strongly recommend Dr Nitish. He knows his job perfectly. He is not money minded at all. He would recommend surgery only if it’s required.

    • Person Image

      I was diagnosed with gall stones a year ago in Delhi, I showed it to a doctor at M.... hospital, he .... asked me to get a surgery done and get my gall removed on any date of my choice, I was sacred and too young to get it done I got a vibe from doctor that for him it’s just a small things, however according to for a patient it’s important first be convinced on the urgency to get it done and feel safe . A year later I shifted to Mumbai and started having a frequent pain in shoulder blades and gall area. It went sharp this time. We went to Dr Nitish , as oppose to Delhi doc, Dr Nitish was very polite, first asked us to get the scan done and understand the current scenario, the scan showed one big 17 mm stone which was earlier also there but this time also there were multiple various sized stones as well along with the big one. Dr Nitish examined the scan, explained me and my husband about the condition and need of surgery or else the stone Would have slipped in the panacea or bile calling for a bigger operation. He explained diagramatically . He was patient in explaining, gave us time to think and be convinced. We were ready and then he performed it . It was flawless, quick and went well. He is a very experienced and fine surgeon , he is caring and doesn’t create panic at all rather he takes it slowly and makes patient comfortable. It was lapro, it’s been 2 months I m writing this . I faced no issues till now. Fortis staff was also very caring and good. I would mention fortis Vashi in specific. Good follow up diet makes it normal. I would strongly recommend Dr Nitish. He knows his job perfectly. He is not money minded at all. He would recommend surgery only if it’s required.

    • Kishore-Kumar-Das

      I had surgery of my left hydrocele on 27th May 2017 by Dr Nitish Jhawar. An excellent experience of service I got particularly from Dr Jhawar. He is not only a qualified experienced doctor but also a splendid human being. Thanks a lot.

    • Siddappa-Hasbi

      It was a Laparoscopic operation for the removal of Gall Bladder (stones). I had developed on and off pain in abdomen before the operation, after the operation feeling good, totally pain free. Thanks and respect for handling my case very well.

    • Person Image

      I met doctor Nitish for piles problem and wanted to undergo LASER procedure only, my operation is successful and I thank doctor for being a good human being and great surgeon.

    • Person Image

      I was suffering from piles since long time. For bleeding heavily I met Dr Nitish Jhawar and after meeting him decided to go for Stapler surgery for piles. I found him a doctor who listens to our problem and explains properly.

    • Person Image

      I got diagnosed about a year back but was avoiding operation for Hernia repair, Dr Nitish Jhawar explained me why surgery should be done and I chose surgery by laparoscopy method. I am happy with the doctor and the hospital.

    • Person Image

      I visited for Gall Bladder removal by Laparoscopy after searching for best laparoscopic surgeon. After meeting dr my fear for surgery was vanished and my surgery went well and recovery was smooth.

    • Person Image

      Honest doctor, expert in his field....can trust his words

    • Person Image

      Very good he describe everything in very pleasant manner about the problem which was very helpful to me to understand my disease.

    • Person Image

      Very nice. Doctor is very patient and gives you correct advice.

    • Person Image

      He is very erudite and smart at getting to the bottleneck of the problem. And before realized he had pinched away d growth bothering me near my anal area.

    • Person Image

      Dr. Jhawar is few of the best doctors in town. Extremely pleasant and comfortable experience