1) Hemorrhoidectomy
Hemorrhoids are swollen blood vessels in anus and rectum. The symptoms requiring immediate operation are as follows:
• Bleeding resulted in anemia that causes dizziness, shortness of breath and easily fatigued
• Blood squirting
• Blood stain on clothes after activity
• Manual reduction of prolapsed piles: after passing stools, you have to manually push-in swollen anus or
   need to lie down for a while
• Prolapsed piles resulting from hard work, sitting in a squatting position or light walking
• Using toilet only at home due to severe prolapsed piles
• Pain around the anus more than once in couple months
• Difficulty in cleaning up after passing stools because of external hemorrhoids or skin tags
• Though not severe, having some of the symptoms listed above and want to be healed

2) Anal fistula operation
Anal fistula is characterized by the following symptoms for which you seek immediate medical attention:
• Pain that worsens when sitting down, moving around, coughing or passing stools
• Pus or bleeding after passing stools
• Irritation of the skin around the anus
• Itchiness around the anus
• High fever of 38°C (100.4°F) or over
• Symptoms that are caused by inflammation of the intestines, including abdominal pain, diarrhea, loss of
   appetite, weight loss, nausea and vomiting.

If you have any of these symptoms, you must get surgery immediately. Prolonging surgery may result in more inflammation, and in rare case it may develop into anal cancer.

3) Anal fissure operation
The main symptoms of anal fissure that require surgery are as follows:
• Pain. An anal fissure causes a severe and sharp pain when passing stool.
   It may even feel like passing broken glass. It is usually replaced by a deep burning pain for a few hours
   after you have been to the toilet.
• Bleeding while passing stools. A bit of bright red blood is usually found, either in the stools or on the
   toilet paper.

The above symptoms appear when the anus becomes too narrow, and it requires immediate operation.

1) Anesthesia
The operation is typically performed under caudal anesthesia. The area of 7-8 cm over the anus is injected, and it would prevent pain for about 10 hours after operation.
Saddle block anesthesia may be administered using a very thin needle, which is less imposing than spinal anesthesia.
General anesthesia, however, is not recommended for you may feel much pain following the operation.

2) Position
You are operated on in the fetal or jackknife position. Your entire body remains covered and only a hole of 10cm in diameter is exposed for the operation to take place.
If you are pregnant, you will be operated on while lying on your side. If you wish, you may listen to music during the operation using an mp3 player.

3) Operation time
a. Hemorrhoidectomy
It usually takes about 40 minutes. In serious cases, it may take over an hour.
b. Anal Fistula Operation
It takes between 10-30 minutes according to the condition. An anal fistula operation together with a hemorrhoidectomy takes between 30-50 minutes.
c. Anal Fissure Operation
It takes just 5 short minutes. An anal fissure operation together with a hemorrhoidectomy takes between 20-40 minutes. It is common that a person with anal fissure may also suffer from hemorrhoids.

4) Method of operation
a. Hemorrhoidectomy
Hemorrhoids operations differ from surgeon to surgeon according to their perspectives. Often times, only the tip is removed leaving the foundation of the hemorrhoids.
At GIBBEUM Hospital, however, we remove the whole hemorrhoid completely. This method of operation has proved to minimize recurrence in over 25,000 operations.
b. Anal fistula operation
The skill of a surgeon for anal fistula operation depends on how well anal sphincter muscle is preserved with minimal damage. Minimal damage to sphincter muscle would reduce recurrence.
At GIBBEUM Hospital, we have devised a new method for this type of operation, which will reduce damage and minimizes recurrence.
c. Anal fissure operation
Anal fissure operation cuts away only the distal half of the internal sphincter, which has hardened and not functioning.
At GIBBEUM Hospital, we treat anal fissure completely and with almost no after effect.

1) Hemorrhoidectomy
At GIBBEUM Hospital, three days of hospital stays is sufficient in most cases, which is a shorter than national average.
We are able to shorten the hospital stay because we perform operations that cause less pain results in quick recovery.

2) Anal fistula operation
At GIBBEUM Hospital, a simple anal fistula operation requires a two days of hospital stay.
A complicated operation may require three days.

3) Anal fissure operation
At GIBBEUM Hospital, a two day stay is required for this operation.
If the operation includes a hemorrhoidectomy three days of hospital stay is necessary.

The day after the operation, we recommend that you start having sitz baths (bathing lower body only), in lukewarm water for three minutes, three times a day. Ointment provided by GIBBEUM Hospital (patent pending) should be applied on the operated area.

It is possible for you to eat after the operation. We recommend that you have soup for two days after the operation, then a low-fiber diet. You will usually pass the first stool 3-4 days after the operation. Passing stools after taking pain-killers will result in less pain. After passing stools, you should have sitz baths.

1) Hemorrhoidectomy
It is common to feel some pain after a hemorrhoidectomy. Some operations leave you feeling no pain after an operation. However, it usually means that the hemorrhoids have not been removed completely. Laser operation is one example of this type of operation. But these types of operations have a higher degree of recurrence. It is much better to remove hemorrhoids completely.

At GIBBEUM Hospital, we will perform operations to minimize both recurrence and pain.

Post-operation pain becomes severe
1. When the effect of anesthesia is in short duration
2. When the operation scar is swollen
3. When the scar is infected
4. When stools are passed very frequently

To reduce pain, at GIBBEUM Hospital we take the following steps:
• We use a special anesthesia that is long lasting.
• We perform operations with care and accuracy to assure the operation scar does not swell.
• We use a special patent-pending ointment suppressing infection of the scar.
• We advise patients to take a special diet to aid in passing stools, which sets us apart from other hospitals.

No treatment is painless. But we offer various special treatments to minimize the pain.

2) Anal fistula operation
Typical anal fistula operation is not painful. Following the operation, it is not painful to pass stools. If you are treated together with hemorrhoids operation, you may feel some pain as in the case for hemorrhoidectomy.

3) Anal fissure operation
You feel no pain following an operation for anal fissure. It is less painful to pass stools following the operation. If you are treated together with hemorrhoids operation, you may feel some pain depending on the result of the hemorrhoids operation.

1) Hemorrhoidectomy
Most patients are worried about post-operation pain. However, the main concern is recurrence. Hemorrhoids typically recur when the operation leaves part of the hemorrhoid tissue. The logic behind this is that many surgeons believe anal cushion is needed for it to absorb shocks when passing stools, and cutting away too much of the hemorrhoid tissue will make the anus narrow.

At GIBBEUM Hospital, however, we remove the whole hemorrhoid completely. This method of operation has proved to minimize recurrence in over 25,000 operations. This is complex and difficult surgery requiring great deal of expertise.

2) Anal fistula operation
There are different types of anal fistula, namely simple and more complicated fistula. The formerrarely recurs after operation. However, the latter requires careful operation to minimize damage to the anal sphincter. The fistula may recur sometimes following surgery. The general rate of recurrence following an operation is between 10-20%. The success of an operation is determined by the rate of recurrence.

At GIBBEUM Hospital, we boast the recurrence rate of 3%, which is much lower than typical recurrence rate.

3) Anal fissure operation
The rate of recurrence following an anal fissure operation is less than 5%.

Once hemorrhoids are completely removed and if well maintained following operation, the anus does not become narrow. 10 days following the operation, you should eat a high-fiber diet, which will help you to pass thick stools so that anus does not become narrow. A simple five minute treatment will help should the anus become narrow.

1) Hemorrhoidectomy
After the operation, you may feel that the anus has become temporally weak. Following surgery it may be difficult to maintain continence. These symptoms will improve in time. The real danger is to undergo surgery from non-specialists. Without sufficient knowledge of the structure and function of the anus, it is possible to damage sphincter muscles during surgery. It is imperative that you seek treatment from specialists in colorectal surgery.

2) Anal fistula operation
Anal fistula operation may damage a portion of sphincter muscles (the ring of muscles that open and close the anus); this cannot be avoided, and it is crucial to minimize the damage. Therefore, it is imperative that you seek treatment from specialists in colorectal surgery.

3) Anal fissure operation
Anal fissure operation cuts a portion of the fibrotic internal sphincter, which makes the anus wider, so that the anus does not tear when passing stools. It is a common concern as the sphincter is cut incontinence (unable to hold stools) will arise. This is not true. Following the operation you may find a little fecal staining, but this will end in time.

Generally patients feel uneasy following anal surgery. Many patients want baby-like clean and aesthetically beautiful anus. In order to provide this, a skilled surgeon with knowledge akin to plastic surgeon is needed.
One of the main reasons past patients of the GIBBEUM Hospital highly recommend to others is due to the quality of surgery and aesthetic results akin to plastic surgery.

Come and experience the GIBBEUM Hospital operation!

	Patients with Korean National Health Insurance	Patients without Korean National Health Insurance
Hemorrhoidectomy	400,000 Won	US $1,550
Anal fistula operation	300,000 Won	US $1,260
Anal fissure operation	250,000 Won	US $1,150

When you get a surgery in our hospital, the cost will be much lower than that in the States even if air travel cost is included. So come and get it. You'll be greatly benefitted.

Please call us at 822-570-1234 to make an appointment between 9:00 a.m. to 8:00 p.m.
Our staff will be happy to answer any questions you may have.
Or you may make an appointment online. Visit us at www.GIBBEUMhospital.com

Come and see what we can do for you for your health.