What is Anal Fistula?
An anal fistula is a small channel that can develop between the end of the bowel and the skin near the anus. An anal fistula can cause bleeding and discharge when passing stools – and can be painful.
An anal fistula can occur after surgery to drain an anal abscess. In some cases, an anal fistula causes persistent drainage.
In other cases, where the outside of the channel opening closes, the result may be recurrent anal abscesses. The only cure for an anal fistula is surgery.
Symptoms of anal fistulas
Pain, which is usually constant, throbbing and worse when patient is sitting down, Skin irritation around the anus, including swelling, redness and tenderness, Discharge of pus or blood, Constipation or pain associated with bowel movements. Infection may worsen and lead to perianal sepsis leading to Fever.
Ignored fistula will keep making tunnels branching below skin or in rectum leading to multiple communication.
Ignored fistula patients may come with complains of stool and gas passing through fistula opening.
Video Assisted Anal Fistula Treatment
Video-assisted anal fistula treatment (VAAFT) is a novel minimally invasive and sphincter-saving technique for treating complex fistulas. Karl Storz Video Equipment is used. Key steps are visualization of the fistula tract using the fistuloscope, correct localization of the internal fistula opening under direct vision, endoscopic treatment of the fistula and closure of the internal opening using a stapler or cutaneous-mucosal flap. Diagnostic fistuloscopy under irrigation is followed by an operative phase of fulguration of the fistula tract, closure of the internal opening and suture reinforcement with fibrin thrombin glue.
The main feature of the VAAFT technique is that the procedure is performed entirely under direct endoluminal vision. With this approach, the internal opening can be found in 82.6% of cases. Moreover, fistuloscopy helps to identify any possible secondary tracts or chronic abscesses. The VAAFT technique is sphincter-saving, and the surgical wounds are extremely small.
- Non Invasive little pain, early recovery back to work quickly
- If Failure can be used again
- Very Low risk of incontinence
- Very good Minimally Invasive approach for complex deep seated abscesses and fistulas esp Crohn’s Fistulas
- VAAFT can be combined with any other technique like Seton and standard open surgical Method by being able to directly visualize and reach high internal opening
- Risk of reopening of internal Fistula opening
- Risk of Recurrence and Multiple Surgeries
Dr Ashish Bhanot
Chief Of Bariatric Surgery & Surgical Gastroenterology Nova Hospitals
Flat No.: 2, Akshardham Apartments
Pocket 3, Sector 19, Dwarka,
For Appointment Call/Whatsapp:
Siri Fort Road