Anal fistula is defined as an abnormal connection or channel between the lower end of the bowel and the skin surrounding the anus. It occurs mainly as a result of infected anal gland
Anal Fistula can be broadly divided into Simple Fistula and Complex Fistula
Anorectal abcess : Almost all anal fistulas are a result of a preceding anorectal abcess. An anorectal abcess begins as an infection of one of the anal glands. The infection soon forms a pool of pus - abcess. An anal fistula results when the abcess fails to heal completely with/without treatment.
Conditions that cause inflammation of the intestines like Crohn's disease, Diverticulitis.
Malignancy in the anorectal region.
Infections : Tuberculosis, HIV, sexually transmitted diseases
Iatrogenic : As a complication of a previous surgery in the region.
Our experienced and internationally trained team offers the best and safest chance of cure with minimal or no pain and discomfort.
Our team offers complete range of latest and most advanced modalities for management of fistula depending on the fistula’s location and complexity.
The various non-surgical laser treatment performed by our team are:
A painless and bloodless procedure usually indicated for simple, low level fistula.
The tract is laid open with the help of laser fiber.
Excellent healing rates with same day discharge.
One of the minimally invasive, low complication rate procedure designed for complicated and complex fistula.
Extremely safe for old age, diabetic and cardiac patients.
No damage to anal sphincter.
A thin radially emitting diode laser probe causes photothermal destruction or ablation of the fistula tract causing it to completely obliterate.
30-minute procedure with same day discharge.
No dressings or follow ups required.
VAAFT is a novel, minimally invasive sphincter saving technique for complex fistula.
This video endoscopic allows direct visualization of the fistula tract and accurate localization of internal opening, a pre requisite for cure of anal fistula.
VAAFT alone was introduced few years back but came into disrepute due to high recurrence.
With the advent of Laser technology and combination of both the procedures, Laser assisted VAAFT has produced excellent results.
The best, minimally invasive, laser assisted procedure for complex fistula where significant proportion of anal sphincter muscles are involved.
Conventional treatment for such fistulae is either extremely painful, requires multiple sittings or carry a high chance of recurrence.
This procedure involves discontinuation of tract with its internal opening at level of inter sphincter plane and then ablating the tract with the help of diode laser.
Highly efficient procedure with almost no recurrences or incontinence.
These are practically non-surgical procedures as it does not involve any tissue cutting or dissection, practically suture free and no requirement of post-operative dressings.
The procedures result in rapid recovery and are almost pain free.
These procedures are extremely safe and cause no blood loss.
The function of anal sphincter muscles is well preserved with zero percent risk of any incontinence.
The recurrence rate is almost zero for majority of fistulas after treatment with laser techniques.
Majority of patients can return back to normal activities after 24 hours of procedure.
Quality is our first concern when it comes to your health and wellness
Our friendly staff is here to answer any questions you may have
Comfort is key to making sure you are happy with the process and outcome
We offer classes to help you maintain a healthy lifestyle after surgery
The time taken for surgery depends upon the type of fistula, whether it is a simple fistula or a complex fistula. The approximate duration of surgery is between 45 minutes to two hours.
We usually discharge the patients on the same day or the next day of surgery.
The fistula is rarely cured by medicines, especially if the fistula gets more than 45 days old. As time passes, the track becomes mature, and no non-surgical method can dissolve the tract or cure the disease.
There is no doubt that fistula can recur or cannot be cured in the first sitting. This is true especially for complex fistulas, have multiple branching, have horseshoe tracts, or have numerous openings.
The best ways to minimize recurrence are:
The majority of our patients can join back their work in four to seven days post-surgery. It all depends on the fistula's complexity and the type of procedure chosen to deal with it.
The majority of the patients don't require any follow-ups. But some of the patients might require irrigation of wounds 2-3 times. We have specialized dressers who can visit your house. They will clean and rinse the wound or tell you how you can rinse the track at home.
The best treatment for fistula depends upon several factors:
Kshar Sutra is an ancient ayurvedic traditional method of treating fistula in Ano. It involves the use of chemical coated thread which is introduced into the fistulous tract. The chemical smeared thread slowly cuts into the fistulous tract.
The procedure is beneficial for the high-level fistulas or the sphincter complex's extensive involvement. Conventional surgeries, in which the fistula tract used to be excised or taken out, can sometimes damage the sphincter complex. In addition, it can cause fecal incontinence, in which the patient loses its capacity to hold the stools.
With the advent of laser surgeries, there is practically no risk of damage to sphincter muscles, so laser surgeries are far better for managing complex fistulas.
The main disadvantage of Kshar Sutra treatment is multiple sittings where the thread is gradually tightened. It is an excruciating procedure, may take weeks to heal the fistula, and maybe a constant source of localized burning or irritation.
Laser surgeries can cure the fistula in a single sitting with no further follow-ups in most patients.
We usually reserve this treatment for highly complex fistulae or in recurrent fistula where the laser treatment has failed to give the desired results.
These innovative procedures are pretty valuable for the management of some complex fistula. Our team, after doing a complete evaluation, decides the best treatment modality. We, however, usually reserve these procedures for long complex fistulas or recurrent fistula where laser treatment has not provided the desired results.
Fibrin glue is one of the latest procedures in which glue or sealant is injected into the fistula tract to seal it completely.
With the help of highly specialized instruments, the fistulous tract is thoroughly cleaned. Then, the internal opening of the tract is stitched closed.
Fibrin glue made from plasma protein is then injected into the tract to seal it completely.
Fibrin Glue technique is an entirely painless procedure associated with a speedy recovery. Moreover, it is a simple procedure that can be repeated in case of failure.
The overall success rate of the procedure varies between 65%-85%.
Extremely safe procedure with zero complication rate.
Suitable for long complex fistulas but not for short and wide fistulas.
Anal fistula plug is a highly specialized plug made from bioabsorbable material derived from the submucosa of the intestine.
It simply inserted into the fistula tract after thorough cleaning of the tract using highly sophisticated instruments.
The body collagen tissue grows over this plug over a period of time, and the fistula tract is completely sealed and healed.
This is extremely useful for a long tract or complex fistulas and has almost zero complication rates. The chances of fecal incontinence (inability to hold the stools), a dreaded complication associated with conventional methods for fistula repair, is practically zero with this procedure.
Early recovery, minimal pain, and no post-operative dressings are some of the additional benefits associated with the procedure.
The high cost of the plug and only an 80% success rate are some of the potential drawbacks associated with the procedure.