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CENTRAL

General Surgery

Laparoscopic surgery

  • Laparoscopic surgery under the principles of minimum operation wound

    Speedy rehabilitation and easing the financial burden of the patient is our Central Hospital’s principles.

Anal Disease

01 Hemorrhoids

What is hemorrhoids?

When the anal passage’s mucous membrane and the skin’s blood vessels experience excessive expansion and increase, it eventually forms a swollen lump of flesh which looks like a water-soaked loofah. This is referred as hemorrhoids.
Since there are swollen lump of flesh at the anal passage, it tends to slip out when you go to the toilet. It even bleeds when the slipped out part is provoked.

What is the cause of hemorrhoids?

Cause of hemorrhoids include all the things that expands the anal passage’s blood vessels.

- old age (blood vessel’s expansion by continuous bowel movement)
- sitting in the toilet too long
- - holding too much strength while defecation
- sedentary work, a habbit of crouching down
- frequent heavy drinking
- exercises that tightens one’s stomach a lot (golfing, hiking, weight training)
- hereditary factors

What are symptoms of hemorrhoids?

Here are some typical symptoms of hemorrhoids.

- Bright red bleeding without pain (usually in large quantity)
- anal prolapse(lump of hemorrhoids slips out when defecation)
- pain (it usually occurs when lump of hemorrhoids gets swollen)
- drooping around the anus

How do we diagnose and examinate hemorrhoids?

There are various ways.

Medical examination by interview:The most important thing in hemorrhoids diagnosis, the symptoms that patients tells us.

Ocular inspection : After medical examination by interview, for accurate diagnosis, we check the anal region with our own eyes.

Digital rectal examination : Doctor uses one’s own fingers to accelerate the inside of the anal and rectum. It not only can check the size of the hemorrhoids, we can also see if there’s anal fissure, anal fistula, or rectal / anal cancer.

Anoscopy : Only if needed, we insert an anal speculum at the rectum and examinate the hemorrhoids.

Anus ultrasonography and anus function test : If you’re planning on a hemorrhoids surgery, this examination is needed for a more accurate identification of the existence of other diseases in the anus, and to check the anal sphincters’ condition.

Colonoscopy : Anyone over age 40, is recommended a colonoscopy. When we perform a hemorrhoids surgery, patients should empty their bowels. So how about getting a colonoscopy on this occasion? Colonoscopy is highly recommended to patients who has ordinarily experienced symptoms of hemorrhage and stomachache and those who have family medical history on colon cancer.

Progression of hemorrhoids

The progression of hemorrhoids depends on the size of the lump of hemorrhoids. Internal hemorrhoid’s progression is sorted starting from 1° degree to 4° degree.

1° degree : The lump of hemorrhoids' size is yet small, it remains only in the inside of the anus. In many cases, 1° degree internal hemorrhoids are not very noticable when there is no bleeding shown.

2° degree: A little bit bigger sized lump comes out of the anus while defecation, and goes right back inside after defecation. When the lump of hemorrhoids slips out during defecation, we call this situation as anal prolapse. 이렇게 용변을 볼 때 항문 밖으로 치핵 덩어리가 밀려 나오는 현상을 탈항이라고 합니다.

3° degree : Much bigger and droopier lump slips out during defecation, but does not goes back in even if you’re defecation is done. It remains still at the outside, and only goes in when I push it in by my hand or wait for a certain time for it to naturally get back in.

4° degree : Anal prolapsed lump refuges to get back in despite of the external pressure. Even when it’s inside, anal prolapse is occurred while daily activities. There are no definated progression states in sorting external hemorrhoids. We can only diagnose the situation by looking at the extent of the external hemorrhoids, and draw a conclusion of the severeness. If you’re experiencing frequent swollen and pain because of frequent blood clot development, it is diagnosed as severe external hemorrhoids.

How to treat hemorrhoids

There are two kinds of treatments, radical and relieving the symptoms. As for radical treatment, we perform total elimination of the lump of hemorrhoids. And for treatments that relieves the symptoms, means without hurting the lump of hemorrhoids, we relieve the symptoms of hemorrhage, pain or edema.

Radical treatment : total elimination of the lump of hemorrhoids. If the lump of hemorrhoids is small in size, it could be burnt by electricity and laser or it could be set apart rotten after tied by an elastic cord. But actually, not a lot of cases are completely cured by these methods. Since many patients visit the hospital with their lump of hemorrhoids already quite big. So as a radical treatment, it is best to reconstruct your anal passage in a normal situation by completely cutting out the lump of hemorrhoids using a scalpel and scissors.

Symptom relieving treatment : n order to relieve hemorrhage, pain or edema, we recommend blood circulation enhancer and anti-inflammatory drugs, and also suppository too. A sitz bath will also help healing the wounds. But using these treatments for a long-term, does not eliminate the lump of hemorrhoids. It can rather cause side effects, so you should be catious about it.

Patients who need hemorrhoids radical operation : 1) Since anemia is caused by severe hemorrhage, you get easily tired, experience dizziness and shortness of breath
2) When you bleed as if you’re shooting blood by a syringe
3) Underwear stained with blood during activities
4) In order to slip in the lump of hemorrhoids, I use my hands or have to lie down for a while
5) Automatical anal prolapse when performing tricky jobs, crouching down and even when simply walking a bit
6) Because of severe anal prolapse, I can only use the toilet in my own house
7) Being swollen or experiencing pain once or more in a cycle of 1~2 months
8) Having trouble wiping of stool because of external hemorrhoids(flesh that droops at the outside of anus)
9) I do not have severe symptoms like above, but wish to cure hemorrhoids

How to self-treatment hemorrhoids?

Self-Treatment to a hemorrhoids is performed to relieve the pain when hemorrhoids is swollen by the blood clot and causes pain and archorrhagia.

1. 1. Warm water sitz bath
2. Remain stable condition
3. Keep your stool soft
4. Adapting to using hemorrhoids suppository and ointment



But remember, self-treatment cannot make the lump of hemorrhoids small. That said, it is impossible to eliminate hemorrhoids redically only by using self-treatments. Some expect a complete cure of hemorrhoids, with the usage of everyday sitz bath and hemorrhoids suppository and ointment. However, using these treatments for a long-term, may worsen hemorrhoids on the contrary. Persisting self-treatments even if you don’t have pain and hemorrhage, is rather harmful to your anal conditions.

How to prevent hemorrhoids

Hemorrhoids is a disease caused by expansion on the anal passage mucous membrane and skin’s blood vessels. The reason why blood vessels expand, is because of increased pressure at it.
So not to increase the pressure at the anal blood vessels are the precautions against hemorrhoids. Specific preventions are:

- - Do not sit on the toilet longer than 5 minutes or for a long time
- - Do not hold too much strength while defecation
- - Do not sit on a warm floor crossed-legged for a long time
- - No crouching down while working
- - Avoid heavy drinking and overworking
-- When participating in exercises that use abdominal pressure such as golfing, hiking, weight training, please be careful.

Blood vessel related disease

01 Varicose vein

What is varicose vein?

Once varicose vein is occurred, it cannot be recovered without an operation.
Many patients think this as a thicken condition of the tendon or blood vessel. But it is actually a disease caused by the weakening of vein’s blood vessel wall under the skin or intravenous valve damage. This makes the vena superficialis to morbidly lengthened, swell and crookedly popped out.
Since the cause, symptom, progression of varicose vein are very different in patient by patient, a complexed application and appropriate choice of various treatments by considering each patient's characteristics are important.

Why is varicose vein caused?

Normal vein blood flow : The valve inside the blood vessel, acts as a blockage that stops blood that comes up goes back down, preventing the blood flowing backwards.

Abnormal vein blood flow : Because of the weakening of vein’s blood vessel wall under the skin or intravenous valve damage, the vena superficialis to morbidly lengthened, swell and crookedly popped out.

How to treat varicose vein

Stripping of varicose vein : A causal treatment, we remove the lengthened vessels by surgery. This treatment cures the fundamental cause of the disease, and has low relapse rate.

Endo Venous laser theraphy(EVLT) : After locating the vessels using an ultrasound, we insert a laser conduit inside the vein. Then block the blood vessels, burning it with a laser light. The strongest point of this treatment is that it is operated in a short time, and able to resume normal activity without hospitalization & general anesthesia.

혈관경화요법 : First, we inject a drug that hardens the blood vessel at the expended ones or major cause region. Then compress the varicose vein region for a certain period. This is mainly used in the treatment of non-severe varicose vein patients with symptoms only below the knee, performed for 3~5 times.

Minor Surgery

01 Lipoma

Lipoma treatment

Lipoma is a benign tumor wrapped around with a thin capsule, that occurs when the fat cell grows. It may occur anywhere in our body, but usually occurs at the dermis found under the skin with normal fat tissues such as abdomen, thigh, arms.

The usual size of a lipoma is 1~3 cm, and feels like a smooth moving rubber ball when touched. Many patients leave it as untreated because even though it is grown in a bigger size, it doesn’t cause particular symptoms.

According to Central Hospital’s medical teams, “Not all lipoma patients should get a removal surgery, but if you feel pain, do not like the looks of it, or have to distinguish it with a malignant tumor, surgery is needed”, “The operation is performed for 5~10 minutes by making an incision in the skin and removing the lipoma after given regional anesthesia”.

But many patients confuse sebaceous adenoma with lipoma and visits the hospital festered after postponing a surgery for a long time. So you must be careful!

02 Cyst

Cyst treatment

Cyst is a membrane or a sac with contents that is clearly distinguished with the tissues around it. The contents inside the membrane may be human derived liquid or a semi-solid, but rarely contains parasite larva, bacteria, or a virus.

Kidney, liver, breast, skin.. etc A cyst can occur in any region on the body. Once a cyst is formed, unless it is removed by a surgery, it does not disappear spontaneously and even last for life. Since most of the cyst is benignant, it does not affect your health deeply. But occasionally may be the signal of cancer, precancerous lesion(a pre-stage lesion of cancer) or a serious underlying disease. So please consult with a specialist.

03 Ganglion

Ganglion treatment

Ganglion is a cystoma(cyst) that contains a bit yellowish slime inside a thin fibrous film. Inside of it, a ganglion is covered with a flat cell. Many of it is connected to a joint or tendinous membrane with a pipe-like line, but some are completely separated with it. Technically it is hardly diagnosed as a tumor, but a tumor-like situation.

As the most common form of tumor that occurs at the hand, some report says that the ganglion takes 50~70% of all the tumors that occurs at the hand. When it comes to sex, a ganglion occurs 2~3 more times in a women patient. And in age-specifics, 20~30s are the most common patient of the ganglion. Has similar frequencies in the both hand, commonly occurs at the back of the wrist. In many cases, the patient remembers an extraordinary injury before the occurrence of a ganglion.

It occasionally disappears spontaneously, or goes away on it’s own but sometimes recurs again. Most ganglion patients do not experience particular symptoms, so not many needs proper treatment.

However in these cases, treatment is mandatory : if it is difficult to verify it as a ganglion, causes pain, shows neurological signs because it compresses the nerve or the tissues around it, or defiles the appearance.