Laser surgery of rectal fissures (fissura ani acuta)

Lengthwise fissure of the rectal mucosa occurs mostly at solid dejection. The app. 1-2-cm-long longitudinal rectal mucosa fissure is extremely painful, and generally it also bleeds. In case of hemorrhoids the inflamed, oedematous, haemophilic mucosa can be easily injured and often these two illnesses occur together: the fissure is considered as complication of hemorrhoids.

First conservative therapy is applied at the occurrence of the illness (fissura ani acuta) (creams, rectal suppositories, settlement of dejecta etc.) since in 70-80 % of the cases due to the use of such, total recovery takes place within 2-3 weeks. In case the fissure may not recover and chronic inflame evolves in its surrounding area and the pain and the tense state of the compressor muscle of the anus becomes continuous (fissura ani chronica), it is only the surgery that provides solution.

A difference is has to be made between the examination of recently formed or earlier (older) fissure to be performed by a surgeon. In case of recently evolved fissure the rectal examination for the pain is impossible, only may the digital (finger) rectal examination is to be performed but at most cases it is neither. Rectoscopy is out of question at this case. Performance of examinations are not forced, patients are provided with drugs and are ordered to appear on a control examination after 3 weeks. In most cases the fissures recover. Not recovering older fissures that are only to be healed by surgery, the examination of the rectum is to be done but for the tense pain of the anus muscle this is only possible in local or general anesthesia. Afterwards the examining doctor gives detailed information for the patient on its state and recommended treatment. Considering the extremely painful inflamed area this operation is cannot be carried out in local anesthesia, only in general anesthesia. One-day-surgery is mentioned here as a special way of treatment together with all the required lab tests and other further exams to be carried out, the anesthesia types, possible complications, home care to-dos, phases of recovery, may occurring problems during recovery, so in a word all and every information that are necessary for the patient to make a decision on the way of treatment and/or surgery. The provided fully detailed oral information is certified by patients with their signature in their own information minute.

Fee of local anesthesia required for the examination: 8.000 HUF > Euro

Fee of general anesthesia required for examination: 30.000 HUF > Euro

Fee of examination and consultation: 10.000 HUF > Euro

If the examination is performed in general anesthesia food and drink intake is allowed till 24:00 pm on the prior day to procedure for patient have to arrive with empty stomach for the surgery!

"One day surgery" means, that patients can leave the outpatient center on their own feet, accompanied by a helper, within 24 hours of surgery (usually after few hours of observation), and continue the healing process in the familiar confines of their own home. "One day surgery" requires strict professional, social, and various other preconditions that are discussed at the stage of the consultation when the need for surgery becomes clear. (I.e.: good general health, absence of serious systemic disease, patient must take responsibility for arrangement of transportation, home care, must have phone to contact the clinic or the surgeon if necessary, etc).

At the booked operative time patients must bring their lab tests, slippers, night-suit. Before placed into sick-room a "STATEMENT" is to be signed in order to entitle our clinic for the performance of the procedure. Besides patients have to undertake home wound care.

Considering that operation is performed in general anesthesia, food and drink intake is allowed until 24:00 pm on the prior day to procedure -for patient have to arrive with empty stomach for the surgery!

Please take the regularly taken drugs in time and dose. Take morning drugs with little liquid at home before departure and in case you may have drugs to be taken in day-time, please bring them with to the clinic!

The operation is only performed in general anesthesia. The mucosa fissure together with its inflamed surrounding area and base is vaporised with "carbon-dioxide laser". The so formed wound healed by secondary wound healing, this leads to defluxion and takes app. 3-4 weeks.

No doctor can guarantee that a complication-free surgery. Complications can arise even following the most carefully performed procedures. The post operative monitoring time spent at the clinic and the steady connection keeping after leaving clinic serves the recognition of eventual early complications (e.g. post-bleeding, fever). Therefore if you recognise any little sign of emerge of complications (e.g. bleeding, fever), you may contact 24/7 your surgeon to solve your problem. Among late complications the damage of the anal muscular system is the most common causing dejecta continence difficulties. This may require further operation. Complications can be prevented by careful post-operative observation and careful operation.

The post-operative observation time is usually 6- 8 hours long, until physiological functions (blood-pressure, urine) get stable again and patients can leave clinic on their own feet with accompany. In the first week of recovery physical load and -work must be avoided but permanent bed-rest is not necessary. The post-operative pain can be well treated by drugs. Post-operative pain in the first 5-7 days may occur spontaneously but mostly at dejections. To terminate this use of painkillers tablets and rectal suppository work supplemented by intervallic chilling of the operative area and camomile bath. Settlement of dejection i.e. regular, soft dejecta during recovery is prominently important. Therefore intake of one spoon of liquid paraffin is proposed 3 times a day but usually no other ejective is necessary. Low-fever may occur on the first post-operative day. On the first post-operative days slight bleeding, later at dejections is not distressing. Defluxion of wound is normal for 3-4 weeks and use of panty-liners are recommended. The total recovery time takes app. four weeks and in this period of time physical load is to be avoided.

Fee of surgery: 0 HUF (paid by National Health Insurance Fund)
Charge for general anesthesia: 40.000 HUF (paid by patient, optional) > Euro
Charge for overnight stay: 0 HUF
Fees of control examinations: 0 HUF (paid by National Health Insurance Fund)

We provide air-conditioned, TV-, phone- and WIFI equipped one-or two-bedded rooms, personal nurse and meal but these mean no further costs for our patients.

Surgery under local anesthesia: 80.000 - 100.000 HUF > Euro
Charge for general anesthesia: 80.000 HUF > Euro
Charge for overnight stay: 30.000 HUF > Euro
Fees of control examinations: 5.000 HUF > Euro

50% of the fee is due at the time the operation is scheduled, as a prepayment.
These are estimated charges and may also be affected by the severity of the condition.

We provide air-conditioned, TV-, phone- and WIFI equipped one-or two-bedded rooms, personal nurse and meal.

INFORMATION ON LASER SURGERY OF RECTAL FISSURES (FISSURA ANI ACUTA)