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.

Patient feel swelling in perianal region which keeps on changing size with bleeding or pus discharge. Pain swelling and discharge increases during episodes of constipation and patient gets some relief after discharge of pus and blood

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.

What is Success rate of Vaaft

The overall healing rate of the VAAFT procedure reported in literature is  54 % to 74% but expert doctors when use it stand alone or combined with other minimal invasive techniques can be as high as 97 % and more

What is risk of fecal incontinence and sphincter damage in VAAFT ?

This technique allows the surgeon to see inside the anal fistula tract and locate the internal opening using an endoscope light. VAAFT helps to treat the anal fistula, preserving sphincter muscles and faecal continence. Endoscope can travel through the sphincter muscles without cutting them helpful in identification and removal of deep fistula tracts.

How painful is VAAFT fistula surgery ?

VAAFT surgery is relatively painless surgery compared to conventional surgery kharsutra surgery and FILAC laser surgery for anal Fistula. After vaaft patient can resume duties as early as 24 hours after procedure.

Diet after VAAFT anal Fistula surgery

Take bland, low-fat foods like plain rice, broiled chicken, toast, and yogurt. Drink plenty of fluids Include high-fibre foods, such as fruits, vegetables, beans, and whole grains.
Good quality protein supplement with soluble fiber is recommended for tissue Growth

What is wound care after vaaft anal Fistula treatment ?

Keeping area clean and dry is important sitz bath is helpful in pain relief and through cleansing of area

What is cost of VAAFT Treatment

Cost of procedure varies from 8000 USD to 15000 USD in different countries but in India Dr Ashish Bhanot performs at very low cost.

How is fistula diagnosed ?

Fistula can diagnosed by examining the area around the anus. As an opening (of the fistula tract) on the skin. Blood and pus discharge on pressing the opening per rectal examination will help to determine how deep the tract is, and the direction in which it is going.many times tract is palpable superficial under perianal skin.

How to manage or treat anal Fistula without surgery

Sitz Bath Soaking in a warm bath 3 or 4 times a day.

Wearing a soft gauge pad over your anal area and frequently changing it till healing is complete.

Eating a diet high in fiber and drinking plenty of fluids.

Using a stool softener or bulk fiber laxative
Avoiding constipation can control disease but not cure it definitive treatment for Fistula is surgery

What is the main cause of Fistula ?

Patients with bowel related disorders like constipation chronic Fissure with painful defecation are prone to Fistula but many persons suffering of diseases like Crohn’s disease and diverticulitis have a higher risk of fistula. Fistula can happen to poeple without bowel disorders though it is rare.

What is postoperative care after VAAFT fistula surgery?

You can put a gauze pad over the opening of the fistula to absorb the drainage, change it as early as it gets wet. Most people can go back to work and their normal routine 1 to 2 days after surgery. Healing time varies from weeks to several months depending upon complexity of anal Fistula.
Normal Sitting on soft surface without special cushions is recommended after surgery

How soon can I start driving after Fistula treatment and resume my work

You can start driving from day 2 of VAAFT anal Fistula treatment and resume work as early as 2nd day of surgery depending upon discomfort

What will happen if a fistula is left untreated

If Fistula is left untreated it will complicate further creating more openings and tunnels under skin like a rodent.It can spread into testes,periprostatic region, penis,scrotum, abdominal cavity, thighs and natal cleft.
Ignored Fistula can turn into malignancy.

Can a perianal abscess heal on its own ?

Anal abscesses require  treatment. treatment is to drain the pus from the infected area by taking an incision on soft part of abcess As per literature about 50 percent of people who have an anal abscess will eventually develop an anal fistula but incidence is much higher than this.most people who had taken treatment for abcess will need Fistula treatment eventually.

What is the cost of fistula surgery VAAFT treatment ?  

The exact cost of the treatment depends on the extent and complexity of the disease and duration of treatment
Fistula treatment is covered under insurance cashless facility is available for Fistula treatment

Why anal Fistula Fistula recurrence is common ?

Fistula is one of most complex diseases involving ano rectal junction because of area of its location and biomechanics of anal canal its difficult to heal. Unless proper closure of internal opening is performed recurrence is sure to happen.
Medicine whatever be it allopathic medicine for Fistula, homeopathic medicine for Fistula or ayurvedic medicine for Fistula it is will just control symptoms of disease closure of external openings is done by nature itself but internal openings needs to be closed for healing of Fistula otherwise it will keep on coming back

How medicine works in Fistula ?

Medicine improve only symptoms of Fistula giving patients false assurance that he has recovered but leakage starts again after stopping medication or many times while taking medications. Medicine for Fistula work on principle of reducing constipation and controlling infection not closing internal opening so will not heal Fistula but will temporarily control it

Can fistula cause Prostatitis

Yes Fistula tract can infiltrate peripostatic capsule and lead to prostatitis

Can fistula causes urinary tract infections?

Yes it can cause and it does not respond to treatment till cure from Fistula. It is usually resistant to most antibiotics

Can fistula in ano travel into testes and scrotum

Yes it can go deep to cause infection and inflammation of testes known as orchitis

Video Assisted Anal Fistula Treatment

VAAFT (Video Assisted Anal Fistula Treatment), is Relatively painless way to treat anal Fistula. Where thin endoscope is used to identify fistula openings and remove its tracts.


  • Non Invasive little pain, early recovery back to work quickly
  • can be performed again if recurrence or another Fistula in surrounding area
  • 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 if constipation persists
    Risk of Recurrence and Multiple Surgeries


What do you mean by VAAFT?

VAAFT or Video Assisted Anal Fistula Treatment basically comprises of a surgical kit. This kit is used for the treatment of anal fistulae. The kit contains the following few items: A video telescope which enables surgeons like Ashish Bhanot, to see inside the fistula...

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Piles & Anal Fistula: What’s The Difference?

Extreme Pain in anus, painful blood-shedding during passing stool, does not mean that you are suffering from Piles problem. It can happen due to anal fistula. Yes! These are also symptoms of complex anal fistula. But the common problem is people are not aware of...

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Associated Hospitals

Fortis Hospitals
Sama Hospital


Dr Ashish Bhanot

Chief Of Bariatric Surgery & Surgical Gastroenterology Nova Hospitals

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