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Stapler / MIPH

Proctology includes all anorectal ailments namely Piles, Constipation, Fistula, Fissure, Pilonidal Sinus &Prolapse .Inamdar Hospital introduces this innovative speciality to all its patients who can now be completely cured from their daily woes of anorectal problems. Dr Ashwin Porwal, ColoProctosurgeon who heads the Proctology Department of Indamdar Hospital focuses on the following :

PILES… A Lifestyle Disease

PILES (clinically known as Haemorrhoids) basically, is the swelling of blood vessels near the anal opening. The lumps are formed by increased pressure on blood vessels in the area, causing them to enlarge and swell. We understand that piles may not be a subject you feel comfortable talking about, but there is no need to suffer in silence.

Grades of Piles….

1) Grade I – Symptoms are mild pain, itching sensation, heaviness where patient can be cured with medicine and diet and Healing Hands Innovative Ayurvedic Therapy.

2) Grade II – Symptoms are painful defecation, recurrent bleeding, itching sensation, burning sensation, dragging sensation, and feeling of prolapse which reduces automatically after motion. This may require surgical intervention.

3) Grade III – Symptoms are painful defecation, recurrent bleeding, itching sensation, burning sensation, dragging sensation, and feeling of prolapse which may require finger reduction after motion. This requires surgical intervention.

4) Grade IV – Symptoms worsen and the prolapse is irreducible. This requires surgical intervention.

Innovative treatment for Piles : STAPLER Surgery

Procedure : It is a minimally invasive painless procedure that reduces the prolapsed HAEMORRHOIDAL (PILES) tissue. A unique stapling technique that is used to push the swollen blood vessels back into their normal position.Preparation : Requires patient to take nothing by mouth about 4 hrs prior to the surgery.Surgery : The surgery takes only about 20 to 30 minutes. It is usually done under spinal anesthesia. It is done through a natural opening (anus), with the help of a use and throw device known as Stapler. In this surgery as there are no cuts and no stitches outside so there is no need of dressing. Post Operative Care (after surgery care) : Patient can have full diet 4 hrs post surgery. He/she can walk around just after 5–6 hrs of the surgery. Patient can be discharged within a span of 24 hrs. On discharge antibiotics and painkiller for7 to 10 days are advised.Recovery : Patient normally gets discharged from the hospital within 24 hrs. The recovery period is relatively very short. Patient can resume daily routine after discharge and join work after 3 days.


Constipation is often one of those topics, very few people like to discuss. It occurs when bowel movements become difficult or less frequent. Constipation is not a disease, but a symptom related to a family of diseases generally classified as 'defecation disorders'.

How do you know..If you suffer from Chronic Constipation?

The following self-assessment can help you determine whether or not you may suffer from chronic constipation.

  • Fewer than three bowel movements in a week.
  • The need to strain at least 25% of the time during bowel movements.
  • A feeling of not being able to complete your bowel movements at least 25% of the time.
  • Hard or lumpy stools at least 25% of the time.

If you have experienced at least two of above symptoms for at least three months, you may have chronic constipation.

If you have Obstructed Defecation Syndrome (ODS) – A type of Chronic Constipation?

If you have chronic constipation and also have one or more of the following symptoms at least 25% of the time during bowel movements, you may have ODS:

  • Multiple trips to the bathroom.
  • Prolonged straining.
  • Incomplete elimination, and/or prolonged time to have a bowel movement.
  • Routine use of laxatives or enemas.
  • The need to press around your genitals or anus to have a bowel movement.

Lucky STARR for Constipation :

Treatment Option :Most of the time, chronic constipation can be relieved using a combination of Diet, Exercise, Medication and Pelvic Floor Physiotherapy.If these approaches do not relieve your chronic constipation, you should discuss treatment options with a Proctosurgeon as you may be suffering from a type of Chronic Constipation known as Obstructed Defecation Syndrome (ODS).Diagnosis : MRI Defecography is a must.

An Advanced Treatment for ODS : STARR SURGERY

Relief from Chronic ConstipationSTARR (Stapled Trans Anal Rectal Resection) is a surgical procedure that is performed through the anus, requires no external cuts and leaves no visible scars. Using 2 surgical staplers, the procedure removes excess tissue in the rectum and reduces the deformities that causes ODS. Patients undergoing STARR are typically hospitalized for 24 Hrs. STARR surgery has a minimal recovery time after leaving the hospital.



Defecography (Scanning of evacuation) is a MAGNETIC RESONANCE IMAGING (MRI) study of defecation, 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.


  • Chronic constipation.
  • Incomplete evacuation.
  • Obstruction & straining during defecation.
  • Fingering during defecation.
  • Patient goes number of times for defecation but does not feel complete satisfaction of evacuation.
  • Daily or alternate day hard stools.
  • Patient has only 2 to 3 evacuations in a week and defecation is a long and time consuming process.
  • Rectal Prolapse (something coming out from anus)
  • Pelvic Prolapse (Bladder & Vagina)

Preparation & Technique for the Procedure :

A jelly paste around 300 to 400 ml is inserted in the anal region of the patient & he is asked to defecate it. All the images during the defecation process are recorded.This technologically advanced investigation is available at a very few places in India. In Maharashtra it is available in Mumbai & Pune.
In Pune it is done only at Fidelity Diagnostics in association with Healing Hands Clinic, located at Inamdar Hospital, Fatima Nagar under the guidance of Proctosurgeon Dr. Ashwin Porwal and his team of trained doctors, staff and an experienced radiologist.


The anorectal Fistula (Fistula in Ano) is an abnormal communication between the anus and perianal skin. Fistula can occur spontaneously or secondary to perianal or perirectal abscess.

Causes of FISTULA :

  • Infection- Anorectal Abscess (Pus)
  • Unhygenic condition of anal region
  • Trauma near anal region
  • Constipation

Symptoms :

  • Discharge from the boil
  • Pain
  • Boils near anal region
  • Non healing wound at anal region
  • Fever & chills

Fistula has a track having 2 openings : Internal in the Rectum or Anus & External in the buttocksDiagnosis : MRI Fistulogram



  • The Fistula track is totally taken out by use of
  • Advanced Radiofrequecy Device under strong light source. Very effective for High Fistula.

VAAFT- Video Assisted Anal Fistula Treatment

  • Innovative Technology for selected Fistula cases only


  • A traditional Ayurvedic Therapy &cutting method.


What is it?

Rectal prolapse is a condition in which the Rectum (the lower end of the colon, located just above the anus) becomes stretched out and protrudes out of the anus.


  • Constipation
  • By Birth
  • Excessive Straining
  • Old Age

Symptoms :

  • Pain
  • Bleeding
  • Mucus Discharge
  • Fecal Incontinence (inability to control bowel movements)
  • Something coming out from anus

Diagnosis :

  • Per Rectal Examination
  • MRI Defecography


  • Surgery is the only Permanent Cure.
  • Latest Innovative STARR SURGERY is Recommended.
  • Usually the surgery takes 30 mins. It is performed through natural anal route without any external cuts.
  • Discharge after 24 hrs, can join office from 5th or 7th day.

After Care :

  • Pelvic Floor Physiotherapy is recommended for 3 to 6 month.

Cancer of the Rectum

The dreaded ‘C’ word- Dealing with Cancer of the Rectum Cancer has become an epidemic to say the very least. Aptly termed ‘Emperor of Maladies’ it has become a nightmare for both the patients and their doctors. But what works in the favor of life and a chance at complete recovery is ‘Prevention’ and ‘Early Detection’.
This principle also applies to cancer developing in the Colo-Rectal Region. Cancer of the rectum is more prevalent in men above 50.

Symptoms :

  • A change in previous bowel habits, such as constipation or diarrhoea
  • Bleeding from the anus
  • Abdominal pain
  • Weight loss

Diagnosis :Colonoscopy & Biopsy
Screening for Cancer Rectum for early Diagnosis
We, at HHC, have been supporting campaigns to aid ‘Prevention of Cancer of the Rectum’ through dietary recommendations such as high fibre diet and early detection by screening tests.TREATMENT : Depends on Stage, Early Stage can be Cured with Surgery.


An anal fissure is a break or tear in the skin of the anal canal. Anal fissures may be noticed by bright red anal bleeding on the toilet paper, sometimes in the toilet. If acute they may cause pain after defecation but with chronic fissures pain intensity is often less.Causes of FISSURE :Constipation
Hard Stool
Delivery & Pregnancy 
Childbirth trauma in womenTREATMENT : 1) Healing Hands Innovative Ayurvedic Therapy 5 – 6 sessions
(Oil Therapy) of short 10 mins for 5 – 7 days in continuity.2) If nothing works : Painless Surgery by 
Radiofrequency (LASER) is the last option.


When Digestion becomes Disruptive…It’s time to beat bloating, acidity, heartburn and the headaches they bring with them
We ingest, the body digests. The story of the food we eat and the nourishment we obtain from it is supposed to be as simple as that. But what if things go a little awry? Early in school we are taught that digestion – simple though it may appear to be- is actually a complex procedure that begins in the mouth itself and involves the esophagus, the stomach and the intestines.
Symptoms :

  • Bloating
  • Constipation
  • Chest pain or burning
  • Abdominal cramps
  • Nausea and vomiting


  • Acidity
  • GERD (Gastro esophageal reflux disease)
  • IBS (Irritable Bowel Syndrome)
  • Gall Stones
  • Appendicitis
  • ODS (Obstructed Defecation Syndrome

We, at HHC can help you to determine the root cause of your digestive disease by detailed dietary history and can treat you 
with minimal medications , Herbals and lifestyle modifications. Conditions like appendicitis and cholecystitis (Gall bladder stone ) can be treated by Laparoscopic surgery.


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