We use medicated thread “Ksharsutra” formulated by us only for treatment of piles, fistula, and fissure only. Only one setting is sufficient for piles. Patient cure within 3-4 days only, but for fistula it depends on the track of the fistula. Every week we call patients for thread-change. Every week the average cutting range is one cm. only. Until thread passes through track, we call patients for thread-change.
In this treatment patient should kept NBM for 6 to 8 hours. Patients should anaesthetized by general or spinal or local. Give lithotomic position for operative. First insert jelly on index finger then do dilatation of anal canal. After stretching apply sponge holders & hold the external surface of the anus. Then take a guaze specie into sponge holder deep into the anal canal. Then withdraw the sponge holder towards you. Automatically piles will come into the anal region. Then catch the piles by pile holder. Insert the curve needle along with linen thread no.40 at the pile base. Transfix the ball like structure and ligate it by 3 knots. Apply Ksharsutra on it. Then excise the ball like structure by scissor. In this manner do the same thing for another piles.
Post Operative Care
- NBM for 8 hrs.
- After that Liquid diet for 2 days
- Support antibiotic, analgesic and laxative – purgative drug.
- Sitz bath is compulsory for 5 days
Importance of Ksharsutra Treatment
No Hospitalization, No pain, No bleeding, Economically less charges than another surgery, Not necessary
Procedure of Ksharsutra
Give lithotomy position to the patient, administer suitable anesthesia. Painting should be done by 1) Savlon 2) Betadine 3) Spirit
In relaxation phase do four finger dilatation anterior, posterior & laterally of the anal orifice. Withdraw your hand from the anal canal, throw out that gloves apply new gloves on both hands, see the sinus of the fistula if it is blind take allyes forcep, apply allyes forcep on the blind surface cut it by scissor, then you will see that there is blood and pus comes from the external site. Take a artery forcep, insert that artery into the track, wide the track by artery forcep remove the artery. Take hydrogen peroxide into the 10CC syringe, insert hydrogen peroxide into the track, while doing this procedure insert one index finger into the anal canal visualize that opening is open or blind.
It fistula is open, then insert probe into the fistulous track & withdraw from the anal canal. Apply Ksharsutra at the tip of probe & again remove the probe by reverse direction, Cut the thread from the probe tip, then suffix the Ksharsutra by two knots.
Changing of Ksharsutra should be done every eight day, while changing the Ksharsutra doctor should know how much cutting & healing appear in eight day. So there is simple method i.e. measure the length of the thread from the knot. In this way changing of Ksharsutra is done properly. One time comes that after catching the Ksharsutra it will automatically come into the hand & in some patient, patient says that he didn’t visualized that Ksharsutra when fall, that means fistula is clear.
For first setting prescribe antibiotic and analgesic. For second setting till the end prescribe, Triphala guggula, Kankayan Vati, Chitrakadi Vati, Abhayarisht, Chitrakasava, Jatyaditaila, Kasisaditaila etc.