Laser Surgery For FistulaClinica2021-12-10T15:04:17+05:30
Fistula Doctor in Kolkata – Laser Surgery
What is an anal fistula?
An anal fistula is a tunnel connecting an infected cyst in the anus to an opening on the skin surrounding the anus. When small glands that produce mucous inside the anus get clogged and infected, it forms abscess or cyst, explains Dr Purnendu Bhowmik, the best fistula doctor in Kolkata. Half of these abscesses have a chance of developing into a fistula.
What causes fistula in ano?
The leading cause of an anal fistula is clogged anal glands that produce mucous and anal abscesses. Other rare conditions that can lead to the development of anal fistula are:
Injury to the anal canal
Sexually transmitted diseases
Diverticulitis (a disease that leads to the formation of small pouches in the large intestine that become inflamed)
Symptoms of Fistula
Symptoms that indicate anal fistula are:
Frequent anal abscesses
Swelling and pain around the anus
Drainage of bloody or foul-smelling pus from an opening around the anus. Pain may decrease after the drainage.
The skin around the anus irritates upon drainage
Pain during bowel movements
Feeling fatigued and suffering from fever and chills
If you experience the above symptoms, visit Clinica Health for the best fistula treatment in Kolkata
Should you treat fistula in ano?
Yes. It must be treated because it doesn’t heal on its own. There is also a risk of developing cancer in the fistula tract if left untreated for a long period of time.
Can fistula be cured?
Yes. A well planned and well executed fistula surgery by the best proctologist in Kolkata can offer complete cure. Most fistulas are simple to treat. But few may pose difficulty when they are complex in nature.
A doctor can usually identify an anal fistula by examining the area around the anus. The doctor looks for an opening of the fistula tract on the skin and determines the track’s depth and direction.
Some fistulas, however, may not be visible on the skin’s surface. A doctor, in this case, will prescribe the following tests –
Anoscopy – A special instrument is used to see inside your anus and rectum.
Ultrasound or MRI – This test allows the doctor to get a better view of the fistula tract.
If the doctor discovers a fistula, he will prescribe further tests to see if the condition is related to Crohn’s disease, an inflammatory disease of the intestine. These studies include blood tests, X-rays and colonoscopy.
What are the treatment options for fistula?
Surgery is the only effective treatment for an anal fistula.
Fistulotomy – Fistulotomy treats a simple fistula that is not too close to the anus. The doctor cuts the skin and muscle surrounding the tunnel open. This procedure allows the opening to heal from the inside out.
Seton – To treat a more complicated fistula, the doctor might insert a tube (seton) into the opening of the fistula. This procedure helps drain the infected fluid before surgery. The seton is left in for six weeks or more.
Advancement flap procedure – A surgeon performs this procedure when a fistula passes through the anal sphincter muscles. Fistulotomy, in this case, carries a high risk of causing incontinence. The surgery involves cutting out the fistula and enveloping the hole leading to the bowel with a flap of tissue removed from inside the rectum.
LIFT Procedure – This procedure treats fistulas that pass through the anal sphincter muscles. A surgeon cuts the skin above the fistula and moves the sphincter muscles apart. Both ends of the fistula are then sealed and cut open so it lies flat.
Endoscopic ablation – An endoscope (a tube with a camera on end) is inserted in the fistula. An electrode is then passed through the endoscope to seal the fistula.
Fibrin Glue – It is the only non-surgical treatment for anal fistula that passes through sphincter muscles. It is not as effective as the other options; however, it helps treat the fistula without hurting the sphincter muscles. The surgery involves the injection of glue into the fistula while under a general anaesthetic. The adhesive seals the fistula and facilitates the healing process.
Bioprosthetic plug – The surgery involves the insertion of a cone-shaped plug made from animal tissue used to block the fistula’s internal opening.
Fistula Laser Treatment – The treatment uses a small laser beam to destroy the fistula walls and granulation tissue, followed by shrinkage and subsequent closure of the track. It is a minimally invasive surgery without any significant safety concerns.
Popular Question regarding Anal Fistula Treatment Answered by Fistula Doctor
Dr Purnendu Bhowmik top Fistula Specialist answers the popular questions regarding anal fistula –
What are the side effects of conventional fistula surgery?
Partial anal stenosis (due to fibrosis during the healing of large perianal wound)
Loss of bowel control (incontinence)
What happens if you develop partial anal stenosis following conventional fistula surgery?
Lifelong medication to pass motion
Straining & bleeding during passage of stool
Abdominal pain due to secondary constipation
What is laser fistula treatment in Kolkata?
The laser surgery for fistula or FiLaC is a minimally invasive surgery in the treatment of anal fistulas. As per the Fistula Surgeon, Fistula Laser Closure (FiLaC) is comparatively new surgical technique in which the fistulous tract is ablated using a ‘radial laser fibre’ resulting in destruction of the fistula walls and granulation tissue followed by shrinkage and subsequent closure of the tract.
Is laser treatment safe for fistula?
Clinica Health provides effective and safe fistula laser treatment in Kolkata. Laser closure of the fistula is a painless treatment and is effective in the case of transsphinteric anal fistula. A conventional surgical procedure, in this case, carries the risk of injury to the anal sphincter (circular muscle), resulting in post-surgery faecal incontinence.
How long is recovery from laser fistula surgery?
Conventional fistula surgery usually takes about 6 – 8 weeks to recover. However, laser fistula treatment only takes a few days to recover and patients can get back to their regular activities.
Anal fistula is a an abnormal communication between the anorectal canal and the perianal skin that is lined with granulation tissue. It occurs as a result of an anorectal abscess, which was previously drained. While the abscess is the acute phase of the disease, fistula represents the chronic phase.
How does it develop?
Infection of the glands in the intersphincteric space between the EAS and IAS is thought to be the primary cause of both acute anorectal abscesses and anal fistulas —the ‘cryptoglandular hypothesis’, described by the best fistula doctor in Kolkata.
How are fistulas classified?
Intersphincteric (45-60%): Intersphincteric anal fistula traverse the longitudinal muscle layer between the external and internal sphincters towards the perineal skin. It does not run through the external sphincter.
Suprasphincteric (3%): Suprasphincteric anal fistulas travel upwards through the intersphincteric space and then curve downwards and cross the levator muscle, reaching the ischiorectal fossa and then the skin.
Transsphincteric (25-30%): Transsphicteric anal fistula travel across the external sphincter into the ischiorectal fossa and head down to the perineum.
Extrasphincteric (<3%): Extrassphicteric anal fistula originates at the rectum or sigmoid colon and extends downward, crossing the levator muscles to reach the ischiorectal fossa.
Considering the origin of the disease, fistula may be categorized as:
Specific or secondary to pathological process, such as ulcerative colitis, tuberculosis, Crohn’s disease, trauma, and other morbid conditions; and
Nonspecific or secondary to infection of the anal glands.
When it comes to diagnosing fistula anatomy, MRI is considered the “gold standard”.
The cumulative incidence of anal fistula in patients with Crohn’s disease is 20-25%. Fistulas are often complex and multiple; this makes the treatment difficult. In this case, anti-tumor necrosis factor-α therapy is considered the first-line treatment. Surgical options are considered if medical treatment fails, but because of the poor rate of wound healing in active Crohn’s disease, a defunctioning colostomy is a more common strategy.
Tuberculosis may be the cause of anal fistula in some cases, says the fistula doctor. Tuberculosis should be suspected in patients who fail to respond to standard treatment or who develop recurrent fistulas. Diagnosis is made through the histological finding of granulomatous disease and the positive identification of acid fast bacilli. Antituberculous drugs are the first line treatment.