Dr. Eisele on FiLaC Laser Therapy
Private Lecturer Dr. Robert M. Eisele has been running his surgical practice in Oranienburg since early 2020. Prior to that, he worked for about 15 years as a surgeon at the Charité, until he moved to Saarland, where he served not only as a senior consultant but even as deputy clinic director at the University Hospital. With his own practice, he now offers patients a wide range of treatments, focusing particularly on outpatient therapy procedures. This also includes the gentle FiLaC laser therapy for anal fistulas.
Dr. Eisele, a specialty where you focus on gentle minimally invasive therapy methods is proctology, which deals with diseases of the rectum. Is a special approach to patients necessary for rectal diseases?
Of course, the anus and all complaints in this region must be diagnosed with the utmost care and treated particularly gently. The threshold to see a doctor is higher than with other complaints, the examination situation is associated with shame, and due to the sensitivity of the anal region, the pain symptoms are often higher than expected. For me as a proctologist, it is important to always remember that the patient is in a special situation when they come to me and to address this individually.
One condition you treat is the anal fistula, a very unpleasant ailment. How does it develop and how can it be recognized?
Anal fistulas are often discovered during an abscess, an extremely painful inflammation in the buttocks area, often originating from inflamed glands in the anal canal. The abscess heals when it can drain through the skin, but the connection to the anal canal remains, and then there is a risk of recurring abscesses.
Can an anal fistula heal on its own, or do I need to have it treated in any case?
There are indeed reports of spontaneous closure rates, but this is not the norm. More often, we see that one hopes and thinks the fistula has closed, and after a while, inflammation develops again. We generally recommend treating the fistula to avoid complications associated with repeated episodes of inflammation.
What treatment methods can you offer patients with anal fistulas?
The treatment of anal fistulas is challenging and primarily depends on the course and staging. Very often, graded treatment sequences need to be coordinated and scheduled. In general, there are numerous available treatment methods. In our experience, minimally invasive therapy forms are best suited, as they minimize the risk of complications such as bleeding, recurrence of the fistula, or a remaining disturbance of sphincter function as much as possible.
Anal fistulas often grow along the sphincter muscle or even through it. How important is sphincter-sparing therapy for patients with this condition?
This plays a significant role. The best treatment success is of little value if one is no longer able to control bowel movements as usual afterward. Since fistula conditions often affect younger people, it is particularly important to consider this aspect. Fundamentally, therapy should never cause more complaints than before the treatment.
You also work with the FiLaC method. What is particularly noteworthy about this treatment method for patients?
It is very well tolerated, can be applied on an outpatient basis, has a high success rate, and a very low complication potential. The cost situation has also developed favorably in recent years, as more and more statutory health insurance companies cover the costs of this therapy. Even in the rare case of a recurrence of the fistula, even after treatment, a repeat procedure can be performed without an increased risk of complications.
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