PD Dr. Jacob treats anal and coccygeal fistulas with laser therapy
In Berlin, PD Dr. med. Dietmar Jacob works in the interregional group practice Surgical Orthopedic Practice Network (COPV) in Steglitz and Zehlendorf. In addition to conventional methods, the experienced general surgeon and proctologist has focused on minimally invasive surgery to offer his patients tissue-sparing and as pain-free treatment as possible. The greatest possible patient comfort and an aesthetically pleasing result are also the focus of minimally invasive treatment of anal and pilonidal fistulas.
Mr. PD Dr. Jacob, how long have you been working with FiLaC® laser therapy?
I have been working with FiLaC® laser therapy for the treatment of pilonidal and anal fistulas since mid-2018 and am very satisfied with this minimally invasive therapy.
What, in your opinion, are the advantages over a classic operation?
Basically, the therapy is associated with significantly less pain than is the case with a classic operation. This is because it is a minimally invasive therapy where only a very small incision needs to be made, or it can even be completely avoided.
The subsequent wound treatment and follow-up care for the treatment of anal or pilonidal fistulas using minimally invasive laser therapy is therefore very simple. In most cases, a classic operation results in a fairly large wound area associated with constant secretion. In contrast, minimally invasive laser therapy enables rapid convalescence – that is, recovery.
Another major advantage of FiLaC® laser therapy is, of course, that the sphincter muscle is not endangered during treatment, thus minimizing the risk of incontinence. This is a very important factor for many patients and decisive for treatment. In addition, the therapy of an anal or pilonidal fistula can be performed on an outpatient basis by experienced surgeons and anesthetists, and no hospital stay is necessary.
Diseases in the rectal area are a taboo subject for many people, and they keep postponing the doctor's visit. Why should one still go to the doctor as early as possible?
Basically, diseases in an early stage are always significantly better to treat than when they are already advanced. For this reason alone, an early doctor's visit is recommended. In addition, it is always advised to see a doctor for complaints lasting more than 4 weeks. This can involve bleeding or constant itching. Inhibitions or shame should not play a role. A proctologist is a specialized doctor who is very familiar with the subject and also knows the fears and inhibitions of the patients.
Is it important to see a specialist?
Yes, a proctologist should definitely be consulted. This specialist is focused on examining the rectum and can carry out appropriate treatment after a thorough examination.
In rare cases, complaints often dismissed as hemorrhoids may hide a malignant growth that must be clarified immediately. Here, early assessment by a specialist is particularly important.
The proctologist also checks whether the patient has taken the important preventive colonoscopy (men from 50 years, women from 55 years) and can provide an appropriate referral.
What is the procedure for treating anal or pilonidal fistulas using laser, and how long does recovery take?
In my opinion, all procedures on the anus and in the so-called anal canal should take place under anesthesia. On the one hand, the surgeon has the opportunity to thoroughly examine the anal canal due to the reduced sphincter activity, which is usually not possible without anesthesia, and can possibly switch to other surgical techniques if this proves medically sensible during the course of treatment. Therefore, patients are always informed about several therapy procedures before an operation, as the detailed examination of the fistula course is only possible under anesthesia.
Follow-up care is very simple. Patients need little to no pain medication in the first three days after the operation and have a small open wound at the anus where the fistula was. This usually still releases some fluid daily in the following 2-4 weeks, so a dressing should be placed in the underwear. After 4 weeks, the fistula is usually healed and closed. Further follow-up care is then no longer necessary.
For the pilonidal fistula, the treatment process is similar. The actual operation under anesthesia takes 10 minutes, and the fistula openings (there are usually more than one) still release some wound fluid in the following 4 weeks. After that, healing is also complete here.
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