A strong team for your health – Help also with anal fistulas, pilonidal cysts and chronic intestinal diseases

Prof. Dr. Derek Zieker-Fischer studied medicine at the University of Tübingen (Germany) and spent semesters abroad in South Africa and Switzerland. After his studies, he worked first as an assistant doctor and later as a specialist at the University Hospital of Tübingen. During this time he acquired the specialist for general and visceral surgery and habilitated.
In 2014, he moved to the DKD in Wiesbaden as senior physician in a managerial position, where he deepened his skills in rectal surgery with the additional title of proctologist.
In 2016, he founded the Surgical Proctology Centre Reutlingen. His teaching activities at the University of Tübingen have kept him in close contact with the University of Tübingen.


Prof. Dr. Zieker-Fischer, The Surgical Proctological Centre Reutlingen is a doctor's office with a "well-defined surgical spectrum". What does that mean?
The Surgical Proctological Centre focuses on the treatment of intestinal and rectal diseases. Preventive coloscopies (examination of the large intestine and often the last part of the small intestine) is also performed here. Using the most modern diagnostic and treatment methods, patient care is carried out at the highest medical and as well scientific level. The surgical-proctological centre is a reference centre in Germany for two leading medical technology companies.

Which treatment methods are these?
The treatment methods depend on the diseases of the patients. The symptoms with which the patients introducing themselves are as varied as the diseases hidden behind them. The therapeutic spectrum ranges from conservative therapies (non-surgical interventions) to various endoscopic and minimally invasive surgical procedures. If possible, we treat on an outpatient basis and usually under general anesthesia.

What exactly are anal fistulas and how do they manifest themselves?
Anal fistulas are inflammatory tissue changes that can run through, between or outside the sphincter muscles. Symptomatic anal fistulas are often caused by the leakage of fluids from the anus and around the anus. The anal fistula is often preceded by an inflammatory change in the anal glands, which in turn can be perceived as an overheated swelling with purulent blood. A persisting anal fistula, which shows the symptoms described above, requires appropriate diagnosis and therapy.

What are the treatment options for anal fistulas?
The treatment of anal fistulas is individual and depends both on their extent and complexity. Fistulae which only have a direct tract and only pass through a small part of the sphincter muscle or no part at all of the sphincter muscle can often be treated directly by surgery by splitting and/or excision. If, however, the fistula passes through larger parts of the sphincter muscle or even appears "fox-like", an individual therapy concept for the affected patient should be developed in any case. This is necessary because the sphincter muscle apparatus is having differences between sex, age, previous illnesses, previous operations and the location of the fistula. Regardless of the surgical procedures selected, the highest priority is always the preservation of stool continence. biolitec's FiLaC method is a therapy method for fistula surgery of the higher located anal fistulas (which are affected by more sphincter muscle tissue). A flexible, thin optical fiber is inserted into the fistula tract and the fistula tissue is destroyed by laser radiation. The radiation intensity can be excellently regulated, so that only the inflamed fistula tissue is destroyed. In addition, the inner fistula duct is then closed. This type of operation is very gentle on the sphincter muscle and thus prevents incontinence caused by surgical therapy.

Are there other diseases that can be treated with the FiLaC method?
In principle, the Filac method can be used where a combination of destruction of inflammatory tissue and simultaneous wound closure is desired. The FiLaC method can also be used, for example, in the area of the gluteal furrow in the pilonidal cyst (pilonidal sinus) or in recurrent abscesses in the context of the chronic inflammatory disease acne inversa (which often occurs in the area of the anus and genitals).


Further information can be found (in German) at: www.chirurgisch-proktologisches-zentrum.de