PILES
CONSTIPATION
FISTULA
HERNIA
PILONIDAL SINUS
DIGESTIVE DISEASES
There was one, then a one hundred and then there were 5000 stories of success, of healing, of caring and cure. In fact, just like several other success stories. This journey of 5000 happily treated patients suffering with Piles also has a humble beginning. It all began in 2008 at a Private Hospital in Swargate, Pune when the first patient, Mr Arun More believed in the healing hands of Dr Ashwin Porwal. This was also the birth of the concept of Healing Hands Clinic. It is at this clinic that the stories of smiles have been scripted. Over the years, this journey of Piles to Smiles has come to be dotted with several sweet memories of patients sharing their experiences of doubts dispelled with trust, pain transformed to relief, and tears changed into joy. Today, Healing Hands Clinic is a family of 5000 surgically treated members & more where each member has a success story to share Moreover, the team at Healing Hands believes that this benchmark is just the beginning of our long term goal of scripting many more stories of smiles
RECTAL CANCER
Our Vision
Innovative and minimally invasive cure for lifestyle diseases every patient educated, cared for and cured of Constipation & Piles. Early diagnosis for prevention and proper treatment of lifestyle diseases in a holistic approach viz. Piles, Constipation, Fistula , Prolapse, Fissure, Pilonidal Sinus, Hernia, Obesity and other Diseases with Medicine, Nutrition & Exercise.
Driving Force
We believe in the best and practice the best. This is achieved at the clinic by taking utmost care of patients and providing them with the best medical and surgical treatment through integrated clinical practices and experience.
Member of ECTA (European Colorectal Technology Association)
Our Founder
Dr Ashwin Porwal graduated from B.J. Medical College, Pune and completed DNB in General Surgery from Poona Hospital and Research Center. He has undergone a certified training in Advanced Laparoscopy, Bariatric Surgery from Genoa Medical School, Italy and Wound Management from Madeleine Flangan University of Hertfordshire, U.K. Dr. Porwal also holds a Diploma in Laparoscopic Surgery from EITS IRCAD, Strasbourg University, France. He has the privilege of having obtained training in Proctology (especially in Constipation & Piles surgery) from the world renowned Colo-Procto Surgeon Dr. Antonio Longo at St. Elizabeth Hospital, Austria. To Dr. Porwal's credit, is the first STARR (Stapled Transanal Rectal Resection) surgery for ODS a form of Chronic Constipation in Maharashtra. He has performed the maximum number of STARR procedures and MIPH (Minimally Invasive Procedure for Hemorrhoids) surgeries for Piles in the state. In 2011, he presented a paper on MIPH and STARR Surgery at the World Congress on Coloproctology in Rome. This year in February, Dr Porwal has achieved a significant milestone of successfully treating more than 2000 Piles patients with the MIPH (Stapler Surgery) procedure & more than 3000 Piles Patients with medicines, which speaks greatly of the care and cure provided by him and his team at Healing Hands Clinic. This milestone is appreciatively dubbed by his team and patients as 5000 Stories of Piles to Smiles To his name is more than 500+ Starr Surgeries which is highest in ASIA.
HOD PROCTOLOGY CLINIC
POONA HOSPITAL APOLLO JEHANGIR HOSPITAL INAMDAR HOSPITAL
Dr Ashwin Porwal
Recently in Feb 2013, He has performed the First Pelvic Organ Prolapse Suspension Surgery (P.O.P.S.) for Pelvic Organ Prolapse in INDIA.
www.storiesofpilestosmiles.org
Our Team
A culmination of practice and hard work Dr. Paresh Gandhi is a successful General Surgeon who has been performing large number of Three Dimensional Mesh Repair for Hernia in Pune, with expertise in hernia surgery without stitches. Dr Paresh Gandhi graduated from N.D.M.V.P.S Medical College, Nasik and completed post graduation in General Surgery from K.E.M Hospital, Pune and received fellowship in General Surgery from College of Physicians and Surgeons in Mumbai. He has undergone certified training in Wound Management from the Madeleine Flangan University of Herfordshire, U.K and Laparoscopic Hernia at K.E.M Hospital, Pune Dr Gandhi also holds a certified training at Abdominal wall reconstruction and Hernia Repair from the renowned Dr. Eduardo ParraDavila from Florida Hospital, Suite. He is currently performing large number of Three Dimentional mesh repair for hernia in Pune. His speciality is repair of obstructed and recurrent hernia.
Dr Paresh Gandhi
Consulting Hernia Specialist
Contributing to the growing corporate culture at Healing Hands Clinic, Mr. Pankaj acts as a Public relation Officer & administers the growth & expansion of HHC.
Dr Anand Ankleshwar
Head Healing Hands Herbs An expert in Constipation & Piles, Dr. Anand Heads Herbal treatment for Piles & Constipation constitution for men patients. Dr Anand also for He plays a pivotal role in pre and post-operative patient follow up and after care.
Dr Sayali Karanjkar
Head After Care Team An expert in after care, Dr. Sayali i s a C o n s u l t a n t d o c t o r, especially for women patients. She plays a pivotal role in pre and post-operative patient follow up and care. She also performs the innovative MRI Defecography test.
Dr Rhujuta Bhalerao
Head Ayurvedic Therapy
Ms Dhanashree Karmarkar
Head Nutrition & Wellness Centre Spreading awareness for prevention of Lifestyle Diseases in the corporates, Ms Dhanashree is specialized in counseling patients suffering from Piles, Constipation and O.D.S (Obstructed Defecation Syndrome) & weight loss management.
Ms Bulbul Aswani
Clinical Nutritionist
Dr Arpita Varshney
Pelvic Floor Physiotherapist
Dr. Rhujuta is a consultant for Ayur vedic Therapy in Constipation & Piles. She plays a pivotal role in pre and post-operative patient follow up and care. She also performs MRI Defecography test.
An important member of the nutrition team, Ms Bulbul is an expert in counseling patients post operatively for diet as well as for prevention of lifestyle diseases.
The only specialized Pelvic Floor Physiotherapist in state. Her treatment plays important role in medical management of Constipation and smooth recovery after surgery for Constipation & Prolapse.
www.healinghandsclinic.co.in
Our Achievements
LIFESTYLE DISEASES
www.storiesofpilestosmiles.org
Our Achievements
1st MRI DEFECOGRAPHY IN STATE
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PILES
CAUSES
Grades of Piles. Depending upon swelling & progression Piles present in 4 stages
Grade I
Symptoms are mild pain, itching sensation, heaviness where patient can be cured with medicine and diet and Healing Hands Innovative Ayurvedic Therapy. 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. 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. Symptoms worsen and the prolapse is irreducible. This requires surgical intervention.
Grade II
Grade III
Grade IV
NOTE : Only 30% of patients suffering from Piles will have bleeding, rest of the patients will have either burning, itching or constipation.
BEFORE SURGERY
STAPLER SURGERY
AFTER SURGERY
Preparation : Requires patient to take nothing by mouth about 4 hrs prior to the 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.
Surgery :
Post Operative Care (after surgery care) : Patient can have full diet 4 hrs post surgery. He/she can
walk around just after 56 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.
NOTE : Stapler Surgery is done with any external cuts, so loss of control post surgery is a myth.
CONSTIPATION
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'.
Diagnosis :
STARR SURGERY
Relief from Chronic Constipation
STARR (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.
Note : In a study, 37% of women who met symptomatic criteria for constipation did not regard themselves as constipated. MRI Defecography can diagnose the type of Constipation.
MRI DEFECOGRAPHY
SYSTEMATIC APPROACH TO CONSTIPATION :
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.
Scanning of evacuation
RECTOCELE
RECTO-RECTAL INTUSSUSCEPTION
WHERE :
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. For appointments kindly call our Doctors on 88882 88885 / 88882 88886
Note : MRI Defecography takes 30 mins and can be carried out anytime without any bowel preparation.
FISTULA
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.
Symptoms :
Causes of
l l
FISTULA
Constipation
Discharge from the boil Pain l Boils near anal region l Non healing wound at anal region l Fever & chills
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Fistula has a track having 2 openings : Internal in the Rectum or Anus & External in the buttocks
Abscess (Pus)
LOW
High
HIGH
Low
Suprasphincteric Fistula 1% Extrasphincteric Fistula 5%
Fistula
Note : Healing Hands Clinic has the highest success rate for Fistula Surgery. Recurrent Fistulas, High Complex Fistula & Surgical Fistula are successfully cured at HHC.
RECTAL PROLAPSE
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.
Symptoms :
Constipation
CAUSES :
Pain Bleeding Mucus Discharge Fecal Incontinence (inability to control bowel movements) Something coming out from anus
Diagnosis :
Per Rectal Examination MRI Defecography
TREATMENT :
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.
Rectal Prolapse
After Care :
Before After STARR Surgery
Note : Pelvic Floor Physiotherapy is a must after Rectal Prolapse Surgery to strengthen the Pelvic Floor.
1st
PELVIC ORGAN PROLAPSE
Pelvic Organ Prolapse is a condition in which the muscles and tissues that support the pelvic organs become stretched, damaged, or weakened, causing the organs they support to drop downward or sag. The pelvic organs include the Vagina, Uterus, Bladder and Rectum. TYPES :
Uterine Prolapse Vaginal Vault Prolapse Cystocele - Bladder drops down into the front (anterior wall) of the vagina. Rectocele - Rectum drops down and bulges into the vagina
P.O.P.S. SURGERY
in INDIA for
Aging Hysterectomy or Prior Pelvic Surgery Menopause Intense Physical Activity Obesity Family History Chronic straining due to Constipation Chronic Coughing Pelvic Floor Trauma during Delivery
Cystocele
Rectocele
After Surgery
Symptoms :
1) Heaviness in the pelvic area that worsens standing, lifting & coughing or as the day passes. 2) Bulge in the vagina. 3) Lower back pain. 4) Leakage of urine (urinary incontinence) during cough, laugh, exercise 5) Constipation. 6) Low sexual activity or painful sexual act.
TREATMENT :
Early : Cured with Physiotherapy (Kegel exercises) - To strengthen Pelvic Floor muscle for better support. Late : Needs PELVIC ORGAN PROLAPSE SUSPENSION (P.O.P.S.) + STARR Surgery (hospitalization for 2-3 days & rest for 1 week) In P.O.P.S. a Y shaped mesh is used to lift the vagina & is fixed to ASIS. (Anterior bony prominence over waist ) Note : If diagnosed early, Pelvic Floor Physiotherapy alone for 6 months gives excellent results.
Diagnosis :
Clinical per rectal & per vaginal examination MRI Defecography & MRI Pelvis
Symptoms :
A change in previous bowel habits, such as constipation or diarrhoea Bleeding from the anus Abdominal pain Weight loss
Diagnosis :
Colonoscopy & Biopsy
Note : If Cancer Rectum is diagnosed early during screening tests... It can be totally cured.
FISSURE
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.
PILONIDAL SINUS
Causes of
FISSURE
l Childbirth
TREATMENT :
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.
A less known about and even more rarely discussed is a condition experienced mainly by young men in their 20s and 30s- some of them develop a small painful swelling just below the spine or between the buttocks. Most ignore it or opt for self medication only to experience reoccurrences and episodes of pus discharge. The truth is that these signs and symptoms are not sporadic but develop as part of the pinodial disease where a sinus tract develops from the source of infection in this anatomical region. Infection in this area develops because of the presence of ingrown hair; the risk also increases in cases of sedentary occupation (a norm nowadays), local irritation and trauma.
TREATMENT :
is the only option l Excision & Primary Closure (Plastic Surgery)
l Surgery
Note : Almost 95% of Fissure Patient are treated purely with medicines & Ayurvedic Therapy at HHC. A money back Guarantee if our therapy fails.
HERNIA
Types of Hernia
Inguinal Hernia Incisional Hernia Femoral Hernia Umbilical Hernia Epigastric Hernia
Chronic Constipation
Straining in bowel movements
TYPES OF HERNIA
Understanding Hernia
A Hernia is a sac formation due to weakness or tear in abdominal muscles. A Hernia occurs when the contents of a body cavity bulge out of the area where they are normally contained. Any activity that increases intra-abdominal pressure can worsen a hernia; examples of such activities are lifting weights, coughing, or even straining to have a bowel movement, or pregnancy.
Poor Nutrition Smoking Over Exertion Undescended Testicles Previous Surgery Pregnancy By Birth
Note : Slow & Gradual weight lifting is advisable to Gym - goers to prevent Hernia.
An 'underlay patch' that provides for an effective posterior repair on the inside of the abdominal wall giving the benefits of Laparoscopic Repair. A 'connector' similar to plug, but smaller and flatter. An 'onlay patch' that fits over the abdominal wall giving the benefits of Open Mesh Repair.
Choose Tension free Hernia Repair A device (Prolene Hernia System) has been designed to overcome many of the disadvantages of tension free hernia repair technique which is currently used primarily to repair direct and indirect inguinal hernia. Benefits of 3D Mesh Repair
1) As the device lies flat against the abdomen, it has virtually no chance of migrating like other devices. 2) 3) 4) 5) 6) 7) Minimal number of stitches. Most important the 3-D mesh device provides the benefits of strong posterior repair like a laparoscopic procedure. Guaranteed Freedom from Hernia. Smaller incision (generally about 4-5cm) Can be done under local Anaesthesia also. Discharge within 24 hours and back to work from 3rd day after surgery.
NOTE : Any Hernia however small it is (even if 1cm), needs surgical repair, because if prolonged the Hernia defect increases with time.
s erb
Digestive Diseases
When Digestion becomes Disruptive
Its 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 beis actually a complex procedure that begins in the mouth itself and involves the esophagus, the stomach and the intestines.
Ask
Symptoms :
Bloating Constipation Chest pain or burning Abdominal cramps Nausea and vomiting
CAUSES :
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.
Note : At HHC most of the digestive diseases are successfully managed by Nutrition Consultation, CONSTACURE Powder & Yoga.
A few Stories...
RECTAL PROLAPSE SURGERY
MEHBOOB SOMJAL
50 yr, Teacher, Satara.
I h a d b e e n s u f fe r i n g f r o m constipation since many years. But as many say some habits die hard. Same was my case. I was used to having laxatives on a daily basis. Years down the line the dosage also increased with my problem. There were times when I didnt pass stools without use of laxatives. Slowly slowly I started having severe hard stools due to which I had to manually remove them during defecation as well. It then dawned on me that I should look into the problem seriously. My digestion was down the drains. I consulted my family doctor who referred me to one of the leading Proctosurgeon Dr Ashwin Porwal. As soon as my history was taken he quickly diagnosed my ailment to be Rectal Prolapse & I was advised to undergo MRI Defecography for ODS. My reports were positive with rectoceles & was further advised to undergo STARR Surgery at Inamdar Hospital. I decided to get it done at the earliest as I wanted relief at the earliest. Today 6 months post surgery I never imagined I could be so better. If I had gone in my preventive stage maybe I would have been cured with medicines as well. All thanks to Dr Porwal for the best surgical treatment given to be. He has made my life heaven!
A few Stories...
STAPLER SURGERY for PILES
KANHAYYA GODHWANI
50 yr, Teacher, Chinchwad. Getting a good doctor is destiny today. Thats what happened with me. My brother got operated for Hernia just a few months before I got operated. He was completely happy with the service & suggested me to consult Dr Ashwin Porwal at the earliest. I was diagnosed for Grade III Haemorrhoids and was explained my problem was not the one to be completely cured with medications & so was advised Stapler Surgery. I had frequent bleeding with hard stools & need to strain while passing stools. My past association with Dr. Porwal for my brother made me undergo surgery without any doubts and hesitation. Today 6 months post surgery I dont believe that I underwent surgery, such is the success of the surgery. I would definitely advise all the patients suffering from Piles to consult Dr Porwal and get the appropriate treatment. The staff, the follow up treatment, the aftercare system & the 24x7 availability of the team even post surgery is mesmerizing and satisfying! Thank you Healing Hands Team for making my life peaceful!
To See the Actual Video Testimonials of these Patient & many more Visit : www.storiesofpilestosmiles.org
A few Stories...
STARR SURGERY for Constipation
STEVE MYRHO
50 yr, Social worker, USA.
stevemdada@yahoo.com I never Ever dreamed in my worst nightmares that Constipation if not prevented on time could lead to surgery. Shifting to India a few years back made me feel heaven. I thought maybe having a good healthy work environment & consulting a few General Physicians would cure me of my 7 year old constipation problem. But day by day my constipation worsened with which I was referred to a leading Proctosurgeon in India Dr Ashwin Porwal by my Physician. Earlier my colonoscopy was done but it was normal and all other tests including sonography were normal . But it was MRI Defecography which diagnosed my problem. I realized I had not followed the 'Prevention is better than cure' & fallen prey to an ailment that can worsen ur daily morning chores. But having such a trustworthy, supportive & medically faithful doctor is something rare that I found in Dr Porwal & decided to get operated at Inamdar Hospital for STARR Surgery for Obstructed Defecation Syndrome that I was suffering from. Today if u see me moving around with zest & zeal u will never believe that in 24 hours this operation that I was scared about took me back home without any pain & suffering & free from constipation for the rest of my life! Kudos to Healing Hands Clinic staff!
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HEALING HANDS CLINIC
4th Floor, Millennium Star Extension, Above KFC Restaurant, Adjacent to Ruby Hall Entrance Gate, Dhole Patil Road, Pune - 411 001 Tel. : 020 - 26164488 / 99 Time : Tuesday &Thursday - 6 to 8pm Saturday 12 to 3 pm
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HEALING HANDS CLINIC
Mangalmurti Complex, Office No. 105, 1st Floor, Near Hirabaug Ganpati, Tilak Road, Pune - 411 002 Tel. : 020 - 24444442 Time : Monday & Wednesday - 11 to 2pm
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