Fistula & Hemorrhoid

The treatment of anal fistula has challenged surgeons for millennia!

The Anal Fistula is a chronically inflamed, abnormal tunnel between the anal canal and the outer skin of the anus. The fistulas develop after spontaneous bursting or after the operation of a perianal abscess. After the abscess has already healed, the fistula remains open and empties the secretions and pus.

Infection of the anal gland (cryptoglandular infectionc) is the leading cause of fistula formation. Other causes include Crohn’s disease, trauma or post-operative surgery.

The majority of fistula, “low anal fistula” is curable. With modern laser therapy (FiLaC), such a simple anal fistula can be treated gently and with low risk.

However, complex, high fistulas are difficult to heal and require special skills for the treatment of such patients. With Ksharsutra therapy, both simple and difficult fistula types can be effectively treated.

In anal fistulas, the Ayurvedic “Ksharsutra method” has gained worldwide recognition in recent years. This is a technique in which the anal fistulas are not surgically cut, but an alkalized medical thread is introduced through the fistula into the anal canal and tied. This medial thread enriched with healing herbs leads to a spontaneous healing of the fistula.

The procedure can be carried out on a day surgery basis, i.e. on an outpatient basis. The dreaded fecal incontinence is excluded with this method.

Hemorrhoids are pathologically enlarged vein swellings (varicose-like or nodular swelling or dilation of a vessel) at the transition area from the rectum to the anal canal. Enlarged hemorrhoids are the most common cause of anal itching, inflammation, bleeding or stool contamination of the laundry. In this case, one speaks of a Hämorrhoidal disease.

Treatment of  Hemorrhoids

First and second-degree hemorrhoids are treated non-surgically. Third and fourth degree hemorrhoids need an operative treatment.

Non-surgical treatments:

  • Sclerotherapy of hemorrhoids
  • Laser Coagulation of Hemorrhoids (LCH)
  • Rubber band ligature of hemorrhoids

If the non-surgical treatment does not bring success or if the haemorrhoidal disease has progressed too far, then surgical treatment is needed.

Modern Painless hemorrhoid surgeries (minimally invasive surgeries)are:

  • HAL-RAR Hemorrhoid surgery
  • Laser Hemorrhoid Surgery (LHP)

Both methods offer some advantages over standard procedures, such as reduced surgical pain and faster recovery.

Anal Fisutla





HAL-RAR Surgery


Laser Surgery


In Anal fistula Ayurveda “Kshar Sutra method” has been found in recent years worldwide recognition. It is a technique in which the fistula will not be cut, but a special alkalized herbal surgical thread is inserted into the fistula canal. This thread is enriched with healing herbs and leads to a spontaneous healing. The thread is pulled out through the fistula, tied and left there. The thread should be changed in 2-3 weeks with a new one. Normally 2-4 treatments are needed.

The procedure can be day surgery. And so it is an outpatient treatment. Since many years it is done in our centre. The dreaded fecal incontinence is excluded by this method.

This ayurvedic method can also be applied successfully in anal fistulas in Crohn’s disease, multiple fistula and the pilonidal sinus.

Download: Info about Ayurveda-Ksharsutra operation

Ayurvedische Ksharsutra

Fistula tract Laser Closure is a minimally invasive new treatment option for fistulas by using radial laser. The aim is a gentle laser radiation of the fistula to collapse the fistula without cutting. Thus any parts of the sphincter muscles are maximally protected and incontinence avoided.

The flexible laser fiber is inserted from the outside of the fistula and positioned accurately with the aid of the pilot light. Through a constant withdrawal speed, energy is introduced into the fistula tract. The fistula shrinks immediately behind the laser fiber. patient brochure (Biolitec)


HAL-RAR (Recto Anal Repair) are minimally invasive treatments for hemorrhoids and rectal prolapse. This method guarantees “no cutting” and “no open wounds”. Therefore this can be referred to as “painless”. The advantages are:

♥ Duration of the operation is about 30 minutes.
♥ 1 Day hospital stay.
♥ Next day able to work.
♥ Successfully applied worldwide.

A special instrument is inserted into the anus. Using ultrasound doppler sensor in the device, the blood-carrying hemorrhoid arteries are located accurately through acoustic signals! These vessels are tied off. This is done in a pain-free zone of the rectum. Thereby, the blood supply to the hemorrhoids and the pressure is decreased. The hemorrhoids become smaller and will disappear after some time. The effectiveness of the HAL method has been proven by many international studies.

This operation is performed in Sanatorium Maria Hilf, the insurance covers the costs.

Download: Info HAL-RAR Hämorrhoiden Operation

The innovative minimally invasive laser therapy enables painless outpatient treatment of hemorrhoids. The big advantage is that the hemorrhoids are not surgically cut and removed.
In contrast to the conventional surgery of hemorrhoids, laser treatment is done without open wounds and this reduces the risk of infection and so it is painless.

This operation is carried out as outpatient in our practice center.

Download: Info Laser Hämorhoidoplastie

A coccyx fistula (sinus pilonidalis) is a chronic inflammatory disease in the buttock fold (coccyx region). The causes of coccyx fistulas are not exactly known. Surgical treatment is required for chronic fistula.

The surgical treatments such as excision and open wound healing, Limberg-diamond-shaped excision and covering, Karydakis-elliptical excision of the skin etc. are extensive operations and the wound healing takes several weeks.

The new minimally invasive procedures are pit picking and laser.

Pit picking laser is a small surgical procedure, is performed on an outpatient basis under local anesthesia and takes about 20 minutes.
Before planning the pit picking laser surgery, the spread and course of the fistula is determined using ultrasound. The visible “pits” are excised under local anesthesia with a skin punch to provide access to the fistula tract. The fistula is cleaned and rinsed out. The fistula tracts are then lasered with a special diode laser fiber and the inflamed fistula tissue and ingrown hair root are carefully cauterized. The cure rate is 80-90 %.

Pit picking laser in pilonidal sinus