Surgeons of Sir Ganga Ram Hospital

+923336303550 (whatsapp messages only, no calls please, book operation appointment only.

Surgeon Dr Imtiaz Hussain (Gold Medalist)
MBBS, Punjab, Pakistan.
FCPS, Pakistan.
FACS, USA.
Dip. Laparoscopic Surgery (Germany)
Certified Pile, Fissure & Fistula Specialist
CHPE (Med Education)
AMC, Australia.

LIFE MEMBERSHIP OF MEDICAL SOCIETIES:
1. Society of Surgeons of Pakistan(LC)-SSP
2. Surgical Oncology Society of Pakistan( SOS-PK)
3. Pakistan Academy of Family Physicians-PAFP® (Regd)
4. Public Relations Coordinator & Secretary of PAFP.

AWARDS & DISTINCTIONS:
Gold Medalist in Academics.
Surgical Jeopardy SURGICON 2011
Award of Excellence FAMILYCON®, 2019


Surgeons of Sir Ganga Ram Hospital

**Sawal:**
Anal fissure ke ilaj ke liye Botulinum Toxin (Botox) injection kaise kaam karta hai?

**Jawab:**
Anal fissure mein bunyadi masla yeh hota hai ke **anal sphincter muscle bohat zyada tight (spasm)** ho jati hai. Is tightness ki wajah se:

* Zakhm (fissure) ko **proper khoon (blood supply)** nahi milta
* Stool pass karte waqt **bohat zyada dard** hota hai
* Zakhm bar-bar phat jata hai aur heal nahi hota

**Botox injection** ka kaam yeh hota hai ke:

1. **Internal anal sphincter muscle ko temporary relax** kar deta hai
2. Muscle ke tight rehne ka signal block karta hai
3. Anus ke andar **blood flow barh jata hai**, jis se fissure ko heal honay ka moka milta hai
4. Stool pass karte waqt **pain aur spasm kam** ho jata hai

Botox ka effect aam tor par **3 se 6 mahine** rehta hai. Is duration mein agar:

* Qabz control kar li jaye
* Fiber aur pani ka sahi istemal ho
* Local ointments aur lifestyle modification follow ki jaye

toh **zyada tar chronic fissures bina surgery ke heal ho jate hain**.

**Botox injection kin patients ke liye behtar hota hai?**

* Jahan medicines aur ointments se faida na ho
* Jo surgery se ghabrate hain
* Jahan LIS (Lateral Internal Sphincterotomy) se pehle conservative option try karna ho
* Female patients ya jin mein incontinence ka risk zyada ho

**Botox ke faide:**

* Surgery ke baghair ilaj
* Hospital stay ki zarurat nahi
* Incontinence ka risk bohat kam
* Procedure quick aur relatively painless

**Botox ke nuqsanat / limitations:**

* Effect temporary hota hai
* Kuch patients mein repeat injection ki zarurat hoti hai
* Har chronic fissure mein 100% kaam nahi karta

---

### **Final Advice from Surgeon Dr Imtiaz Hussain:**

Agar anal fissure purana ho chuka hai aur dawaon se theek nahi ho raha, toh Botox injection **surgery se pehle ek behtareen aur safe option** hai. Lekin yaad rakhein, **qabz ka control aur diet correction** ke baghair koi bhi treatment mukammal kamyab nahi hota. Har patient ke liye treatment plan **individual assessment** ke baad decide hona chahiye.

---

### **Surgeon Dr Imtiaz Hussain (Gold Medalist)**

**General & Laparoscopic Surgeon**
Certified Piles, Fissure & Fistula Specialist

**Qualifications & Credentials:**

* MBBS
* FCPS
* FACS (USA)
* Diploma in Laparoscopy (Germany)
* CHPE (Medical Educationist)
* Fellow of American College of Surgeons
* Certified ATLS Trauma Course by American College of Surgeons

---

### **Expertise of Dr Imtiaz Hussain**

* Piles, Fissure, Fistula aur Perianal Problems
* Laparoscopic Gallbladder aur Appendix Surgery
* Thyroid Diseases aur Surgery
* Breast Cancer, Fibroadenoma aur Lumps
* Lipomas, Sebaceous Cyst aur Lumps & Bumps
* Scrotal Problems
* Hernias (Inguinal, Femoral, Umbilical, Epigastric) aur Varicose Veins
* Amputations aur General Surgeries

**Appointment ya Online Consultation ke liye (WhatsApp – text only):**
**+923336303550**
How to treat Chronic Anal fissure with Botox injection | Stepwise Procedure Explained | Dr Imtiaz
https://youtu.be/d4UDNTzXyng

1 week ago | [YT] | 5

Surgeons of Sir Ganga Ram Hospital

**Sawal:**
Grade 3 piles (hemorrhoids) par **rubber band ligation (RBL)** kyun dangerous ho sakta hai aur iska **proper ilaj** kya hai?

**Jawab:**
Grade 3 piles wo hote hain jo **stool ke waqt nikalte hain (prolapse)** aur **apni jagah wapas manually push karni padti hai**.

### **Rubber Band Ligature (RBL) ka risk Grade 3 piles mein:**

1. **Large / Prolapsed Piles:**
Agar pile bara hai aur continuously prolapse ho raha hai, RBL **complete removal ke bajaye sirf base ko band karta hai**.

* Is se **incomplete necrosis** ya tissue ka ulta effect ho sakta hai
* Zyada dard aur bleeding ka risk barh jata hai

2. **Pain aur Infection:**
Large pile ke RBL ke baad zyada dard, infection aur kabhi kabhi **abscess ya sepsis** ka risk hota hai

3. **Recurrence:**
Grade 3 piles mein RBL se aksar **pile dobara aa jate hain**, kyunki underlying tissue aur supporting ligaments weak hote hain

4. **Thrombosed Pile Risk:**
Agar pile already thrombosed hai, RBL karna aur dangerous ho sakta hai

---

### **Grade 3 piles ka Proper Ilaj:**

1. **Surgical Hemorrhoidectomy:**

* **Milligan-Morgan** ya **Ferguson technique** preferred hai
* Ye complete removal deta hai aur recurrence kam hoti hai
* Hospital stay 1–2 din ho sakta hai

2. **Stapled Hemorrhoidopexy (PPH):**

* Agar internal prolapsed pile ho aur patient ko pain kam chahiye
* Recurrence moderate, post-op pain kam

3. **Conservative / Non-surgical (Early Stage hi ho to):**

* High fiber diet, stool softener, sitz bath
* Sirf temporary relief deta hai, Grade 3 mein aksar insufficient

---

### **Surgeon Dr Imtiaz Hussain ki Final Advice:**

“Grade 3 piles par RBL aksar safe nahi hota, khaas tor par bade prolapsed piles ke liye. Surgical hemorrhoidectomy ya stapled hemorrhoidopexy zyada effective aur long-term solution hai. Conservative ilaj sirf symptom relief ke liye kaam aata hai.”

---

## **Surgeon Dr Imtiaz Hussain (Gold Medalist)**

**General & Laparoscopic Surgeon**
Certified Piles, Fissure & Fistula Specialist

* MBBS
* FCPS
* FACS (USA)
* Diploma Laparoscopy (Germany)
* CHPE (Medical Educationist)
* Fellow of American College of Surgeons
* Certified ATLS Trauma Course by American College of Surgeons

---

## **Expertise of Dr Imtiaz Hussain**

* Piles, Fissure, Fistula aur Perianal Problems
* Laparoscopic Gallbladder aur Appendix Surgery
* Thyroid Diseases aur Surgery
* Breast Cancer, Fibroadenoma aur Lumps
* Lipomas, Sebaceous Cyst aur Lumps & Bumps
* Scrotal Problems
* Hernias (Inguinal, Femoral, Umbilical, Epigastric) aur Varicose Veins
* Amputations aur General Surgeries

---

**Appointment ya Online Consultation ke liye (WhatsApp Text Only):**
+923336303550
Treatment for Haemorrhoids | Rubber Band Ligation
youtube.com/shorts/Dbj2ElQXjy...

1 week ago | [YT] | 1

Surgeons of Sir Ganga Ram Hospital

**Sawal:**
Gallbladder (pittay) ki pathri ke liye **cholecystectomy** ke baad kya **motion (dast)** lag sakte hain؟ Agar lagte hain to **kyon lagte hain**, aur **care aur ilaj** kya hai؟

**Jawab:**
Haan, gallbladder nikalne ke baad kuch logon ko **motion lag sakte hain**. Isay **post-cholecystectomy diarrhea** kehte hain. Yeh zyada tar **temporary** hota hai.

### **Motion kyon lagte hain؟**

1. **Bile ka direct flow:**
Gallbladder ke baghair bile (pitt) seedha intestine mein girti rehti hai. Yeh bile zyada miktar mein ho to intestine ko irritate kar ke motion karwa sakti hai۔

2. **Fat digestion ka change:**
Surgery ke baad charbi (fat) hazm karne ka tareeqa badal jata hai. Charbi zyada ho to motion ho sakte hain۔

3. **Gut sensitivity:**
Kuch patients mein intestine surgery ke baad kuch arsay tak sensitive rehti hai۔

4. **Dietary triggers:**
Tez mirch masalay, fried food, doodh ya caffeine se motion barh sakte hain۔

---

### **Care (Parhez aur Routine):**

* **Chhoti quantity mein khana**, magar bar-bar
* **Low-fat diet** (tali hui cheezon se parhez)
* **Dahi** ya probiotic foods
* **Zyada pani** piyen (dehydration se bachne ke liye)
* Coffee, soft drinks, zyada meetha aur spicy cheezon se parhez

---

### **Ilaj (Agar motion zyada hon):**

* Aksar cases mein **2–6 hafton** mein khud theek ho jata hai
* Doctor ki salah se:

* **Anti-diarrheal** medicines (jaise loperamide)
* **Bile-binding medicines** (cholestyramine) agar bile zyada ho
* Agar motion ke sath **weight loss, bukhar, khoon** ya raat ko bhi motion hon to **check-up zaroori** hai

---

### **Surgeon Dr Imtiaz Hussain ki Final Advice:**

“Cholecystectomy ke baad motion aana aksar arzi hota hai. Diet control aur thora waqt dene se zyada tar patients bilkul normal ho jate hain. Agar masla barqarar rahe to simple medicines se control ho jata hai—is liye pareshan honay ke bajaye proper follow-up karein.”

---

## **Surgeon Dr Imtiaz Hussain (Gold Medalist)**

**General & Laparoscopic Surgeon**
Certified Piles, Fissure & Fistula Specialist

* MBBS
* FCPS
* FACS (USA)
* Diploma Laparoscopy (Germany)
* CHPE (Medical Educationist)
* Fellow of American College of Surgeons
* Certified ATLS Trauma Course by American College of Surgeons

---

## **Expertise of Dr Imtiaz Hussain**

* Piles, Fissure, Fistula aur Perianal Problems
* Laparoscopic Gallbladder aur Appendix Surgery
* Thyroid Diseases aur Surgery
* Breast Cancer, Fibroadenoma aur Lumps
* Lipomas, Sebaceous Cyst aur Lumps & Bumps
* Scrotal Problems
* Hernias (Inguinal, Femoral, Umbilical, Epigastric) aur Varicose Veins
* Amputations aur General Surgeries

---

**Appointment ya Online Consultation ke liye (WhatsApp Text Only):**
+923336303550
Vomiting after Gallbladder Surgery | Cause & Treatment | Nausea & Vimiting | Home Remedies
https://youtu.be/cx0SrrhwlSQ

1 week ago | [YT] | 1

Surgeons of Sir Ganga Ram Hospital

**Sawal:**
Anal fissure mein stool pass karnay ke baad kaafi der tak pain hota rehta hai — yeh kion hota hai aur iska ilaj kya hai?

**Jawab:**
Anal fissure mein stool pass karne ke baad der tak pain rehne ki sab se badi wajah **anus ke andar muscle (internal anal sphincter) ka spasm** hota hai. Jab sakht ya dry stool fissure wali zakhmi jild se guzarta hai to zakhm phir se khul jata hai. Is se muscle reflex mein tight ho jati hai, jise spasm kehte hain. Yeh spasm blood supply ko kam kar deta hai, jis ki wajah se zakhm ko healing ka moka nahi milta aur pain **stool ke baad ghanton tak** rehta hai.
Is ke sath sath burning, mirch jaisi jalan, itching aur kabhi kabhi halki bleeding bhi ho sakti hai.
Ilaj ka bunyadi maqsad teen cheezen hoti hain:

1. stool ko soft rakhna,
2. muscle spasm ko relax karna,
3. zakhm ko heal honay ka time dena.

**Medical ilaj** mein high-fiber diet, pani zyada peena, stool softeners, garam pani ka sitz bath aur doctor ke mashwaray se fissure healing ointments (jaise sphincter relaxant creams) shamil hoti hain. Aksar fresh fissure 4–6 hafton mein theek ho jata hai.
Agar fissure purana (chronic) ho jaye, pain bohat zyada ho, ya medicines se faida na ho to **surgical options** jaise lateral internal sphincterotomy consider ki jati hai, jo controlled tareeqay se muscle ka spasm khatam karti hai aur zyada tar cases mein permanent relief milta hai.

---

### **Final Advice from Surgeon Dr Imtiaz Hussain:**

Anal fissure ko ignore na karein. Qabz, der tak toilet mein baithna aur apni marzi se cheezen lagana fissure ko purana aur ziddi bana deta hai. Agar stool ke baad pain ghanton tak rehta hai ya 6 haftay mein behtari nahi aa rahi to qualified colorectal surgeon se proper check-up zaroor karwaein, taake bar waqt sahi ilaj ho aur surgery se bachaya ja sake — aur agar surgery zaroori ho to woh bhi safe aur effective tareeqay se ki ja sake.

---

### **Surgeon Dr Imtiaz Hussain (Gold Medalist)**

**General & Laparoscopic Surgeon**
Certified Piles, Fissure & Fistula Specialist

**Qualifications:**
MBBS
FCPS
FACS (USA)
Diploma Laparoscopy (Germany)
CHPE (Medical Educationist)
Fellow of American College of Surgeons
Certified ATLS Trauma Course by American College of Surgeons
FACS (USA)

---

### **Expertise of Dr Imtiaz Hussain**

* Piles, Fissure, Fistula aur Perianal Problems
* Laparoscopic Gallbladder aur Appendix Surgery
* Thyroid Diseases aur Surgery
* Breast Cancer, Fibroadenoma aur Lumps
* Lipomas, Sebaceous Cyst aur Lumps & Bumps
* Scrotal Problems
* Hernias (Inguinal, Femoral, Umbilical, Epigastric) aur Varicose Veins
* Amputations aur General Surgeries

📱 **WhatsApp (text only) for appointment or online consultation:**
**+923336303550**
Why is there still pain after we pass stool in Anal Fissure? #drimtiazhussain #generalsurgeon
youtube.com/shorts/xz6h36L3dh...

2 weeks ago | [YT] | 2

Surgeons of Sir Ganga Ram Hospital

**Question:**
Are the chances of recurrence higher in **direct inguinal hernia** or **indirect inguinal hernia**?

**Answer:**
**Direct inguinal hernia has a higher chance of recurrence than indirect inguinal hernia.**

**Reason (in simple terms):**

* **Direct hernia** occurs due to **weakness of the posterior wall** of the inguinal canal. Even after repair, the surrounding tissues may remain weak, especially in older patients, smokers, or those with chronic cough or constipation.
* **Indirect hernia** occurs because of a **congenital patent processus vaginalis**. Once this sac is properly dealt with during surgery, the surrounding tissues are usually stronger, so recurrence is **less common**.

**Factors that increase recurrence in both types:**

* Poor tissue quality
* Smoking
* Chronic cough or constipation
* Obesity
* Heavy weight lifting too early
* Infection or improper mesh placement
* Non-mesh (tissue) repair in adults

**Important note:**
With **modern mesh repair (open or laparoscopic)** and proper technique, recurrence rates for **both direct and indirect hernias are low**, but **direct hernia still carries relatively higher risk**.

---

### **Final Advice from Surgeon Dr Imtiaz Hussain:**

Hernia recurrence depends more on surgical technique, mesh use, and patient factors than on hernia type alone. Quit smoking, control cough and constipation, and follow post-operative instructions strictly to minimize recurrence.

---

## **Surgeon Dr Imtiaz Hussain (Gold Medalist)**

**General & Laparoscopic Surgeon**
Certified Hernia, Piles, Fissure & Fistula Specialist

**Qualifications & Credentials:**

* MBBS
* FCPS
* FACS (USA)
* Diploma Laparoscopy (Germany)
* CHPE (Medical Educationist)
* Fellow of American College of Surgeons
* Certified ATLS Trauma Course by American College of Surgeons
* FACS (USA)

---

## **Expertise of Dr Imtiaz Hussain**

* Hernias (Inguinal – Direct & Indirect, Femoral, Umbilical, Epigastric)
* Piles, Fissure, Fistula & Perianal Problems
* Laparoscopic Gallbladder & Appendix Surgery
* Thyroid Diseases & Surgery
* Breast Cancer, Fibroadenoma & Lumps
* Lipomas, Sebaceous Cyst & Lumps & Bumps
* Scrotal Problems
* Varicose Veins
* Amputations & General Surgeries

**WhatsApp (Text Only) for Appointment or Online Consultation:**
+923336303550
Inguinal Hernia Mesh Repair | Lichtenstein Repair | Operation of Hernia | Surgeon Dr Imtiaz
https://youtu.be/8GCvOL1b2Xc

1 month ago | [YT] | 3

Surgeons of Sir Ganga Ram Hospital

**Question:**
Can small haemorrhoids turn into cancer, and how would we know without getting any tests?

**Answer:**
**No — haemorrhoids (piles) do NOT turn into cancer.** Haemorrhoids are swollen veins, while cancer is uncontrolled growth of abnormal cells. They are **completely different diseases**.

However, the **problem is confusion**, not transformation. Early colorectal or anal cancer can sometimes **mimic haemorrhoid symptoms**, which is why people delay diagnosis.

**Without tests, you can only suspect — not confirm.** Here’s how to differentiate **by symptoms alone** (not 100% reliable):

**Features more suggestive of haemorrhoids:**

* Bleeding is **bright red**
* Bleeding happens **with stool or straining**
* Pain is related to stool passage
* Symptoms come and go
* Lumps reduce or go back inside

**Red flags that raise concern for cancer (even without tests):**

* Bleeding **without pain**
* Bleeding that continues **even when stool is soft**
* **Unexplained weight loss**
* **Change in bowel habits** (new constipation/diarrhea, thin stools)
* **Persistent weakness or anemia**
* A hard lump that **does not reduce**
* Symptoms **not improving** with standard haemorrhoid treatment
* Age **over 40–45 years** with new bleeding

⚠️ Important:
**You cannot reliably rule out cancer without examination or tests.** Symptoms alone are not enough.

---

### **Final Advice from Surgeon Dr Imtiaz Hussain:**

Haemorrhoids themselves never become cancer, but assuming all rectal bleeding is piles can be dangerous. Any person above 40 years with persistent bleeding, pain, or change in bowel habits should get a proper examination. Early diagnosis saves lives.

---

## **Surgeon Dr Imtiaz Hussain (Gold Medalist)**

**General & Laparoscopic Surgeon**
Certified Piles, Fissure & Fistula Specialist

**Qualifications & Credentials:**

* MBBS
* FCPS
* FACS (USA)
* Diploma Laparoscopy (Germany)
* CHPE (Medical Educationist)
* Fellow of American College of Surgeons
* Certified ATLS Trauma Course by American College of Surgeons
* FACS (USA)

---

## **Expertise of Dr Imtiaz Hussain**

* Piles, Fissure, Fistula & Perianal Problems
* Laparoscopic Gallbladder & Appendix Surgery
* Thyroid Diseases & Surgery
* Breast Cancer, Fibroadenoma & Lumps
* Lipomas, Sebaceous Cyst & Lumps & Bumps
* Scrotal Problems
* Hernias (Inguinal, Femoral, Umbilical, Epigastric) & Varicose Veins
* Amputations & General Surgeries

**WhatsApp (Text Only) for Appointment or Online Consultation:**
+923336303550
Rubber Band Ligation | آپریشن کے بغیر موکۓ کا علاج | Non Surgical Treatment of Piles/ Haemorrhoids
https://youtu.be/h5g2C_zmCQY

1 month ago | [YT] | 2

Surgeons of Sir Ganga Ram Hospital

**Sawal:**
Umar 44 saal hai, pehlay chhotay piles ke mokay thay, ab piles walay mokay baray ho gaye hain jo khud bahar aa jate hain, andar push karne se wapas chale jate hain aur ab dard bhi hota hai — is ka ilaj kia hai?

**Jawab:**
Aap ki baat se lagta hai ke aap ko **Grade-III Internal Piles** hain. Is stage par piles ke mokay stool ke waqt bahar aa jate hain aur **haath se andar push karne par wapas chale jate hain**, jabke ab dard ka hona aksar **soojan, zakhm (fissure), ya thrombosis** ki wajah se hota hai.

**Ilaj ke options:**

1. **Initial (agar soojan zyada ho):**

* Stool soft rakhna (fiber + pani)
* Warm sitz bath
* Short course medicines (pain & swelling ke liye)

> Yeh sirf temporary relief deta hai, permanent ilaj nahin.

2. **Non-Surgical Procedures (selected cases):**

* **Rubber Band Ligation:** Mokay ke base par band lagaya jata hai
* **Injection Sclerotherapy / Infrared Coagulation**

> Grade-III mein yeh kam effective hotay hain, aksar dobara problem hoti hai.

3. **Definitive / Permanent Ilaj (Recommended):**

* **Surgical Hemorrhoidectomy** (open ya closed)
* **Stapled Hemorrhoidopexy** (selected patients)
* **Laser Piles Surgery** (agar suitable ho)

Agar piles ke sath fissure bhi ho to **combined treatment** ki zarurat hoti hai, warna dard aur healing ka issue rehta hai.

---

### **Final Advice from Surgeon Dr Imtiaz Hussain:**

Is stage par sirf medicines par waqt zaya na karein. Proper examination (proctoscopy) ke baad definitive treatment plan banwana bohat zaroori hai. Jitni dair hogi, piles aur zyada baray aur painful ho sakte hain.

---

## **Surgeon Dr Imtiaz Hussain (Gold Medalist)**

**General & Laparoscopic Surgeon**
Certified Piles, Fissure & Fistula Specialist

**Qualifications & Credentials:**

* MBBS
* FCPS
* FACS (USA)
* Diploma Laparoscopy (Germany)
* CHPE (Medical Educationist)
* Fellow of American College of Surgeons
* Certified ATLS Trauma Course by American College of Surgeons
* FACS (USA)

---

## **Expertise of Dr Imtiaz Hussain**

* Piles, Fissure, Fistula aur Perianal Problems
* Laparoscopic Gallbladder aur Appendix Surgery
* Thyroid Diseases aur Surgery
* Breast Cancer, Fibroadenoma aur Lumps
* Lipomas, Sebaceous Cyst aur Lumps & Bumps
* Scrotal Problems
* Hernias (Inguinal, Femoral, Umbilical, Epigastric) aur Varicose Veins
* Amputations aur General Surgeries

**WhatsApp (Text Only) for Appointment or Online Consultation:**
+923336303550
Cancer & Piles both mimic Symptoms
youtube.com/shorts/uHQUVn9ShB...

1 month ago | [YT] | 1

Surgeons of Sir Ganga Ram Hospital

**Q: Mujhe mesh se infection ho gaya hai. Ab dobara mesh use nahi hoga? Kya simple (non-mesh) operation ho sakta hai? Kya approach aur solution hota hai?**

**A: Mesh infection hernia surgery ka sab se mushkil complication hota hai. Agar mesh infected ho jaye to amuman mesh ko remove karna parta hai, lekin dobara hernia repair *bilkul possible* hota hai. Approach case ke hisaab se decide hoti hai:**

---

## **1. Mesh Infection ka Pehla Step — Mesh Removal**

Agar mesh deeply infected ho gaya hai, discharge aa raha hai, sinus ban gaya hai ya antibiotics se control nahi ho raha, to surgeon mesh ko **completely remove** karta hai.
Mesh ko lagay huay tissue se nikalna delicate surgery hoti hai.

---

## **2. Dobara Mesh Kab Use Kiya Jata Hai?**

Aik misconception yeh hota hai ke “infection ke baad mesh dobara nahi lag sakta.”
**Yeh galat hai. Mesh lag sakta hai — lekin same area me turant nahi.**

3 Surgeries hoti hain:

### **(A) Staged Repair (Best & Safe Option)**

* Pehle surgery: infected mesh remove + infection control
* Dusri surgery: kuch weeks ya months baad jab wound bilkul clean ho jaye
* Tab laparoscopic approach se **new mesh** safely lagaya jata hai
Yeh duniya bhar mein safest approach mani jati hai.

### **(B) Immediate Non-Mesh Tissue Repair (Bassini / Shouldice)**

Agar infection zyada ho, tissue weak ho, ya mesh dobara nahi lag sakta ho, to surgeon **non-mesh tissue repair** karta hai.
Lekin iska **recurrence rate mesh repair se zyada hota hai**.

### **(C) New Mesh in a Different Layer (Laparoscopic TEP/TAPP)**

Agar pehli surgery open thi aur mesh superficial infected hua tha, to surgeon naya mesh **andar se laparoscopic technique** (TEP/TAPP) se laga kar reinforcement karta hai.
Is se infection ka risk kam hota hai.

---

## **3. Kaunsa Mesh Dobara Use Kiya Jata Hai?**

* Laparoscopic hernia repair me **lightweight polypropylene mesh**
* Kabhi kabhi **biologic mesh** bhi use hoti hai, agar infection ka risk high ho
Surgeon patient ke weight, infection history, tissue quality ke hisaab se choose karta hai.

---

## **4. Infection ke Baad Non-Mesh Repair Ka Risk**

Non-mesh repair bhi ek option hai magar:

* Recurrence high
* Tissue tension zyada
* Recovery slow
Is liye hernia specialists usually staged mesh repair prefer karte hain.

---

## **Final Advice — From Surgeon Dr. Imtiaz Hussain**

Mesh infection stress create karta hai, lekin aap ka hernia *bilkul theek ho sakta hai*. Sab se behtareen tareeqa staged approach hai: pehle infected mesh remove karna, phir infection settle karna, aur phir laparoscopic layer me naya mesh laga kar strong, long-term repair karna. Har patient ka case different hota hai—sab se important hai ke aap aik experienced hernia surgeon se proper evaluation karwain.

---

# **Surgeon Dr. Imtiaz Hussain (Gold Medalist)**

**General & Laparoscopic Surgeon**
**Certified Piles, Fissure & Fistula Specialist**
**MBBS, FCPS, FACS (USA)**
**Diploma Laparoscopy (Germany)**
**CHPE (Medical Educationist)**
**Fellow of American College of Surgeons**
**Certified ATLS Trauma Course by American College of Surgeons**
**FACS (USA)**

---

## **Expertise of Dr. Imtiaz Hussain**

* Piles, Fissure, Fistula aur Perianal Problems
* Laparoscopic Gallbladder aur Appendix Surgery
* Thyroid Diseases aur Surgery
* Breast Cancer, Fibroadenoma aur Lumps
* Lipomas, Sebaceous Cyst aur Lumps & Bumps
* Scrotal Problems
* Hernias (Inguinal, Femoral, Umbilical, Epigastric) aur Varicose Veins
* Amputations aur General Surgeries

---

### **For Appointment or Online Consultation (Text Only):**

**WhatsApp: +923336303550** (text only)
Inguinal Hernia Mesh Repair | Lichtenstein Repair | Operation of Hernia | Surgeon Dr Imtiaz
https://youtu.be/8GCvOL1b2Xc

1 month ago | [YT] | 2

Surgeons of Sir Ganga Ram Hospital

**Sawal:**
Kia fissure theek honay ke baad thori si kharish rehna normal hai, aur kia yeh smoking ki wajah se bhi ho sakti hai?

**Jawab:**
Ji haan, fissure ki ilamat theek honay ke baad halki si kharish rehna kaafi cases mein **normal** hota hai, khas taur par jab zakhm healing phase mein hota hai. Is ki chand aham wajahain hoti hain:

* **Healing process:** Jab fissure bhar raha hota hai to nayi skin banti hai, is dauran kharish mehsoos hona aam baat hai.
* **Dryness ya ointment ka asar:** Kuch logon mein zyada dafa ointment laganay ya area dry reh janay se bhi kharish hoti hai.
* **Moisture ya sweating:** Anal area mein pasina ya nami rehne se irritation aur kharish barh sakti hai.
* **Smoking ka role:** Smoking bilkul kharish aur fissure ke issues ko barqarar rakh sakti hai. Smoking se

* blood circulation kam hoti hai
* healing slow ho jati hai
* skin dryness aur irritation barhti hai
Is liye smoking fissure ke baad rehne wali kharish ko **worsen** kar sakti hai.

Agar kharish zyada ho, jalan, discharge, ya dard dobara shuru ho jaye to yeh secondary infection, allergy ya fissure ke incomplete healing ki nishani ho sakti hai, jiska check-up zaroori hota hai.

---

### **Final Advice from Surgeon Dr Imtiaz Hussain:**

Smoking ko kam ya band karna fissure ki complete healing ke liye bohat zaroori hai. Fiber wali ghiza, pani zyada, soft stool, aur anal hygiene ka khayal rakhein. Baghair mashwaray ke steroid ya strong creams ka istemal na karein. Agar kharish 1–2 hafton se zyada rahe ya barhti jaye to specialist se consult zaroor karein.

---

## **Surgeon Dr Imtiaz Hussain (Gold Medalist)**

**General & Laparoscopic Surgeon**
Certified Piles, Fissure & Fistula Specialist

**Qualifications & Credentials:**

* MBBS
* FCPS
* FACS (USA)
* Diploma Laparoscopy (Germany)
* CHPE (Medical Educationist)
* Fellow of American College of Surgeons
* Certified ATLS Trauma Course by American College of Surgeons
* FACS (USA)

---

## **Expertise of Dr Imtiaz Hussain**

* Piles, Fissure, Fistula aur Perianal Problems
* Laparoscopic Gallbladder aur Appendix Surgery
* Thyroid Diseases aur Surgery
* Breast Cancer, Fibroadenoma aur Lumps
* Lipomas, Sebaceous Cyst aur Lumps & Bumps
* Scrotal Problems
* Hernias (Inguinal, Femoral, Umbilical, Epigastric) aur Varicose Veins
* Amputations aur General Surgeries

**WhatsApp (Text Only) for Appointment or Online Consultation:**
+923336303550
Why itching when Anal Fissure is Healed ? Causes and Treatment | Home Remedies
https://youtu.be/Nv8OnUCb0jc

1 month ago | [YT] | 8

Surgeons of Sir Ganga Ram Hospital

**Q: Hernia ka mesh se operation karne ke baad agar dobara hernia ho jaaye to phir kya karna chahiye?**

**A: Hernia mesh repair ke baad hernia ka dobara hona (recurrent hernia) kam hota hai, lekin agar ho jaaye to uska ilaj phir se surgery hi hota hai — jise “recurrent hernia repair” kehte hain.**
Is mein surgeon case ke hisaab se aik behtareen technique choose karta hai:

### **1. Open Repair with New Mesh**

Agar pehli dafa laparoscopic surgery hui thi to dobara usually **open mesh repair** ki jati hai. Is mein purani tissue weakness ko strengthen karte hain aur naya mesh laga kar repair ko mazboot banaya jata hai.

### **2. Laparoscopic Repair (TEP / TAPP)**

Agar pehli dafa open surgery hui thi to dobara laparoscopic technique behtar hoti hai. Laparoscopic approach se andar se hernia defect ko theek kiya jata hai, scar tissue kam hota hai aur recovery tez.

### **3. Purane Mesh ka Assessment**

Kabhi kabhi mesh ke side se weakness hoti hai. Surgeon purane mesh ko remove nahi karta — sirf weak area ko reinforce karta hai.

### **4. Lifestyle Risk Control**

Recurrent hernia ka risk tab barhta hai jab:

* Bhaari wazan uthaya jaye
* Chronic cough ho
* Constipation ho
* Obesity ho
* Surgical site infection hua ho
Is liye in tamam cheezon ko control karna zaroori hai.

### **5. Surgery Delay Na Karein**

Dobara hernia pehli se zyada weak hota hai aur complications ka risk barha deta hai (strangulation / obstruction). Is liye time par ilaj behtareen hota hai.

---

## **Final Advice — From Surgeon Dr. Imtiaz Hussain**

Agar mesh repair ke baad hernia dobara aa jaye to ghabraana nahi. Recurrent hernia ka ilaj possible hai — bas is ki technique thodi different hoti hai. Sab se aham baat yeh hai ke procedure aik experienced hernia surgeon se karwaya jaye jo open aur laparoscopic dono approaches mein expert ho. Early checkup aur timely repair aap ki long-term health aur recovery ko secure karti hai.

---

# **Surgeon Dr. Imtiaz Hussain (Gold Medalist)**

**General & Laparoscopic Surgeon**
**Certified Piles, Fissure & Fistula Specialist**
**MBBS, FCPS, FACS (USA)**
**Diploma Laparoscopy (Germany)**
**CHPE (Medical Educationist)**
**Fellow of American College of Surgeons**
**Certified ATLS Trauma Course by American College of Surgeons**
**FACS (USA)**

---

## **Expertise of Dr. Imtiaz Hussain**

* Piles, Fissure, Fistula aur Perianal Problems
* Laparoscopic Gallbladder aur Appendix Surgery
* Thyroid Diseases aur Surgery
* Breast Cancer, Fibroadenoma aur Lumps
* Lipomas, Sebaceous Cyst aur Lumps & Bumps
* Scrotal Problems
* Hernias (Inguinal, Femoral, Umbilical, Epigastric) aur Varicose Veins
* Amputations aur General Surgeries

---

### **For Appointment or Online Consultation (Text Only):**

**WhatsApp: +923336303550 (text only)**
Inguinal Hernia Mesh Repair | Lichtenstein Repair | Operation of Hernia | Surgeon Dr Imtiaz
https://youtu.be/8GCvOL1b2Xc

1 month ago | [YT] | 1