Why Surgery, Can Medicines Help?
A fistula is known as the connection of two body cavities or as the connection of a body cavity to the skin, which is not a normal occurrence.
Anal Fistulas Seldom heal by themselves, so they need surgery.
The Type of surgery depends upon the the type of the fistula which is determined by MR Fistulogram.
Who will do the surgery?
The general Surgeon or the Colorectal Surgeon will be handling this surgery. It is usually done under General Anaesthesia.
What could be the complications of the surgery?
Bowel Incontinence. Damage to the sphincter muscles (the ring of muscles that open and close the anus) which could potentially result in loss of bowel control.
Recurrence of fistula.
Prolonged Infection.
The Types Of Surgery Available
- Fistulotomy
- Seton techniques
- LIFT procedure
- VAAFT
- VAAFT + LIFT
- Bio-prosthetic plug
FISTULOTOMY
The most common type of surgery for anal fistulas.
This involves cutting along the whole length of the fistula to open it up so it heals as a flat scar.
Usually only suitable for fistulas that don’t pass through much of the sphincter muscles.
SETON TECHNIQUE
A piece of seton or surgical thread is passed through the fistula tract.
It tightened periodically to cut through the fistula gradually
This is done in cases of complex fistulas where
– multiple opening are there.
– Fistula passes through a significant portion of the muscle
LIFT Procedure. (Ligation Of Intersphincteric Fistula Tract)
Relatively new treatment for anal fistulas
It’s designed as a treatment for fistulas that pass through the anal sphincter muscles, where a fistulotomy would be too risky.
During the treatment, A cut (incision) is made in the skin above the fistula.
The sphincter muscles are moved apart.
The fistula is then sealed at both ends and cut open so it lies flat.
VAAFT ( Video Assisted Anal Fistula Treatment)
Technique is performed for the surgical treatment of complex anal fistulas and their recurrences.
The internal opening of the fistula is closed .
The entire path of the fistula is destroyed by electrocautery under direct telescopic vision.
Bio-Prosthetic Plug
This is a cone-shaped plug made from animal tissue that is used to block the internal opening of the fistula.
The Spectrum of surgery ranges from open to endoscopic depending upon the type of The Anal Fistula.