We all have hemorrhoidal cushions in the anal canal and they work, together with the sphincters, to guarantee a good continence. Hemorrhoidal disease is due to the prolapse of rectal tissue, causing hemorrhoids to slide down in the anal canal, enlarge and eventually bleed.

Because traditional treatments of hemorrhoids can be extremely painful and uncomfortable, many patients prefer to live with the problem rather than seeing their doctor. Now - at Dr.Rami Hamed Center - instead of painful operations, we offer the newest minimally invasive techniques for hemorrhoids treatment that allow patients to have very few to no pain and quick return to daily activity. 

Procedure for Prolapse and Hemorrhoids (PPH) or Longo stapled anopexy, together with Stapled Trans Anal Rectal Resection – STARR, are the only surgical procedures able to remove, with a circular stapler - in a permanent way - the prolapsed tissue causing the disease. We also practice the laser technique and the arterial ligation and pexy. All these techniques can be performed in a Day Surgery setting, guaranteeing a short, smooth and painless postoperative course and quick return to daily activities.

 Anal fistula is an abnormal connection between anal canal and perianal skin, causing important discomfort for the patient with pain, purulent discharge and anal itching.

Traditional techniques, such as the ‘seton’ are extremely painful and cause a lot of discomfort to the patients because of the constant anal discharge together with the needing of many painful medications.

 Between new techniques for anal fistula treatment, Video Assisted Anal Fistula Treatment (VAAFT) has a high healing rate and the near to zero pain and incontinence.

This new surgical technique is performed with a special fistuloscope is the only that allows to perform both a diagnostic and a curative phase at the same time.

 This procedure is performed in Day Surgery and the patient can go home and have shower the same day. Healing is registered between 7 and 21 days, depending on the complexity of the fistula, with no need of painful dressings or special visits. The patient is able to resume daily activities in 2-3 days.

An anal fissure is a tear of the anal skin that cause: dull pain during and after defecation, anal itching and peri-anal skin irritation, discomfort and anal bleeding.

Anal fissures can be caused by: passage of large and/or hard stool, repeated diarrhea, childbirth that can also cause trauma to the anal canal or prolonged muscular spasm.

It can be acute, which heals by itself in few days, and chronic with no healing in 12 weeks. 

Initially, medical therapy with special local ointment, stool softener and pain killers is attempted. 

If the fissure is not healing in 3 months and scar tissue is forming, then anal fissure surgery is the only way to guarantee healing to the patient.

Normally, surgical cauterization (diathermy) under sedation is the only necessary treatment. In more advanced cases, anal flap is necessary in order to make the fissure healing correctly. 

In the few cases where the muscle spasm is the main causative component, a little incision on the inner sphincter might be necessary, always taking utmost care to safeguard the continence.

All the procedures are performed with minimally invasive techniques, allowing the patient to be operated in a Day Surgery setting, with less pain and quick return to daily activities.

Pilonidal Sinus (or Pilonidal Cyst or Coccygeal Fistula), is a cyst located in the upper cleft of the buttock, above the sacrum, containing hair that can form abscesses. Is a very fastidious disease, causing pain and embarrassing purulent discharge.

If the patient presents with a non-infected sinus, elective minimally invasive surgical treatment for pilonidal sinus or cyst is pursued and the patient can resume daily activities the same day after surgery.   

At Dr. Rami Hamed Center, we are proud to offer – first in the UAE – a new minimally invasive treatment for pilonidal sinus called EPSiT. This is a very innovative method - performed only with a tiny 5 mm incision on the sinus itself and a special fistuloscope, with no ugly scars and painful wound medications. The result is a tiny 5 mm incision, without any post-operative pain and immediate possibility to resume daily activities like walking, showering and even sport.

This technique is especially designed for professional football players and other sport competitors needing to early resume daily activity but gives a big advantage to all patients, therefore avoiding the long postoperative course of the traditional techniques and the ugly scar.

There is no need of any paying particular attention, except a twice a day washing with saline solution of the small incision.

Esthetic results are excellent already after 7-10 days.