LASER SURGERY FOR FISTULA IN ANO (Bhagander)

Fistula in ano is an abnormal epithelialized tract that communicates the anal canal or rectum with perianal skin outside.
It starts as an infection in cryptoglandular anal glands leading to perianal abscess which than bursts and forms a tract. The other causes of fistula formation are Inflammatory bowel disease like ulcerative colitis/crohn’s disease, tuberculosis, neoplasia etc.
This condition was first described 2500 years back. Its estimated incidence is over one lakh new cases every year in India. Ideal treatment for fistula is surgical eradication of sepsis and promote healing of the tract, whilst preserving the sphincters and the mechanism of stool continence.
FISTULA ARE OF VARIOUS TYPES AND TREATMENT OPTION MAY VARY ACCORDINGLY


Types of Fistula

COMMON SYMPTOMS OF FISTULA
1. Persistent discharge of pus from external opening of perianal area.
2. Pain and swelling in perianal area.
3. Fever
4. Bleeding
5. Multiple openings on perianal region making even sitting uncomfortable

Surgery is the only definitive treatment for fistula cure. The primary aim of surgery is healing; however, success of fistula surgery is influenced by a variety of factors – surgeons experience, type of fistula (simple or complex), involvement of sphincter muscles, type of surgical procedure and patient related factors

There are various methods to treat fistula including fistulotomy, fistulectomy, seton placement, Fibrin glue and plugs, VAAFT and now newly developed Laser surgery for Fistula (FiLAC)

Laser is a novel sphincter saving surgery which uses laser emitting probe/ fibre which destroys the fistula epithelium and simultaneously obliterates it resulting in shrinkage and complete closure of the tract in 360 degree manner. In it the tract is not excised so that minimal postoperative pain is experienced by the patient. Also since the depth of laser energy is limited there is no damage to sphincter muscles so the chances of incontinence is minimal.

 

                                  Thin laser fibre

 

ADVANTAGES

1. Short procedure
2. Short hospital stay
3. Minimal pain
4. Early back to work
5. Can be repeated with minimal discomfort if recurrence happens
6. Minimum chances of incontinenece
7. No cutting


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