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Institute of Laparoscopic Surgery

Leparoscopic Surgery Training

Anal Fistula

Anal Fistula Also known as fistula-in-ano, it is a common anorectal condition in which an abnormal channel/connection develops between the inner surface of the anal canal and the skin near the anus.

 

Why do anal fistulas develop?

Anal fistulas originate at the site where the anal glands drain into the anal canal. Blockage of these glands cause secretions to accumulate inside leading to abscess formation which can eventually point to the skin surface. In this process, the tract that is formed is referred to as an anal fistula.

 

The fistula tract can branch into the fascial layers of the perianal region causing the fistula to spread. If the fistula seals, abscesses can also recur leading to accumulation of pus which may again point towards the skin surface at the same or different site, thus repeating the process. In such cases, more than one fistula openings are formed.

 

Treatment procedure

Fistulotomy/Fistulectomy are the surgical treatment options for the treatment of anal fistulas. These procedures identify the fistula tract with its internal and external openings and destroy the fistula path.

 

However, these procedures require open surgery and prolong the period of recovery as regular painful dressings are needed for weeks or months. Infection can be a serious complication of these procedures which may result in an anal abscess indicating another surgery. One major disadvantage of conventional fistula surgeries is that it can cause damage to the sphincter muscles which can affect the patient's bowel control and lead to incontinence. Chances of recurrence exist.

 

What is Minimally Invasive Fistula Treatment (MAFT)?

The Video-assisted Anal Fistula treatment (VAAFT) in India is described as MinimaIly-invasive Anal Fistula Treatment. MAFT(VAAFT) is a major breakthrough treatment option for complex fistulas and their recurrences. It is a minimally invasive laparoscopic technique. The Video assisted anal fistula treatment in India is described as MAFT(VAAFT).

 

This technique involves the examination of the fistula path using an endoscope to determine the point of the internal opening of the fistula. This is followed by closing the internal opening of the fistula using a stapler and the entire fistula tract is destroyed under direct telescopic vision by electrocautery.

 

Why MAFT(VAAFT) over conventional procedure?

Since the procedure is minimally invasive, there is no surgical wound in the perianal region and hence no dressings are required. As there is no damage to the anal sphincter hence, the risk of fecal incontinence is ruled out. Early recovery and least post operative pain enables the patient to resume daily activities from the same day of surgery.