An anal fistula( Bhagandar ) is almost always the result of a previous abscess. Just inside the anus are small glands. When these glands get clogged, they may become infected and an abscess can develop. A fistula( Bhagandar ) is a small tunnel that forms under the skin and connects a previously infected anal gland to the skin on the buttocks outside the anus.
The anorectal Fistula( Bhagandar ) ( Fistula in Ano ) is an abnormal communication between the anus and perianal skin.Fistula can occur spontaneously or secondary to perianal or perirectal abscess.
- Discharge from the boil.
- Boils near anal region.
- Non healing wound at anal region
- Fever & chills
Fistula has a track having 2 openings : Internal in the Rectum or Anus & External in the buttocks
Investigation: MRI Fistulogram
Causes of Fistula:
- Infection- Anorectal Abscess ( Pus )..
- Unhygenic condition of anal region.
- Trauma near anal region.
- Fever & chills
- The Fistula track is totally taken out by use of Advanced Radio frequency Device under strong light source.
- A traditional Ayurvedic Therapy &cutting method.
Surgery for fistula
An abnormal passageway formed between the anal canal and the skin surface is referred to as Fistula.
Superficial fistula tracts are usually cut open; while deeper fistulae are cut out. However, the patients suffer from a lot of pain during these procedures. In case of severe stage fistulae, surgical intervention is not always possible and recurrence risk is always present. It is tough for individuals to tolerate the pain and even if they sustain with it, the quality of life is extremely poor. On the other hand, “FiLaC surgery for fistula” gently destroys the tissue and closes the fistula by a laser probe inserted into the fistula tract. Maximum conservation of the sphincter muscle and fast healing are the key benefits of the treatment procedure.
Laser surgery for fistula
An anal fistula is an abnormal passageway formed between the anal canal and the skin surface. The anal glands & their outlets get blocked, which results in infection of surrounding area. Thus, the fistula is formed with an inflamed nature. Treatment of fistulae involves total elimination/removal of the fistula tract. The conventional surgical procedures are quite painful and cumbersome; therefore a latest treatment procedure Minimally Invasive - one of which is the “laser surgery for fistula” is recommended. During this surgery, the fistula tract is removed gently by inserting a flexible, radial laser fiber from the outside of the tract. The fundamental principle of this Laser Surgery is to destroy a tissue in a controlled way and let the fistula tract collapse thereby.
Treatment of fistula depends on the position, location & complexity. LIFT ( ligation of intersphincteric fistula tract ) procedure is a modified technique performed for deep & complex fistula treatment. LIFT procedure is based on secure closure of the internal opening and removal of infected cryptoglandular tissue. The LIFT procedure allows the access of the fistula between the sphincter muscles and avoid cutting of them.
There are some basic steps that are followed during LIFT procedure:
- Identifying the internal opening of fistula tract
- Incision at intersphincteric groove
- Dissection through intersphincteric plane to find intersphincteric fistula tract
- Secure suture ligation of intersphincteric fistula tract
- Removal of the fistula tract
- Curette fistula tract from external opening
- Suture closure of external sphincter muscle defect
- Closure of intersphincteric wound
VAAFT - Video Assisted Anal Fistula Treatment
The VAAFT procedure is performed for the surgical treatment of complex anal fistulas & also for their recurrences cases. Surgical wound in the perianal region are prevented and the risk of faecal incontinence is avoided because no sphincter damages are provoked.
The VAAFT procedure comprises a diagnostic phase and an operative phase.
- The diagnostic phase
The purpose of the diagnostic phase is the correct localization of the internal fistula opening.
- The operative phase
Purpose of this phase is the destruction of the fistula from the inside. As a next step, the fistula ca nal is cleaned / the waste material removed & its internal opening is then hermetically. This procedure assures a perfect excision and a hermetic closer of the internal fistula opening, excluding the risk of stool passage.
The advantage of the VAAFT procedure can be seen evidently as no surgical wound on the buttocks or in the perianal region are seen. This is because the fistula is completely destroyed from the inside.
During the VAAFT procedure a local or GA anaesthesia is given. The procedure is a painless procedure carried out for 20 minutes. The recurrence rate is also negligible after the process of VAAFT. VAAFT procedure is performed only for the selected cases of fistula depending on the clinical diagnosis by a Fistula surgeon.
The post-operative care is also must after VAAFT procedure. A timely follow up with doctor is must to keep the area clean & to have a close care on healing of wound. Post-operatively medications for 2 weeks are strictly to be followed along with exercise and diet given by the experts. One can resume its duty immediately after3 days of surgery is also the major benefit of this procedure.
The Anorectal Fistula( Bhagandar ) ( Fistula in Ano ) is an abnormal communication between the anus and perianal skin. Fistula( Bhagandar ) can occur spontaneously or secondary to perianal or perirectal abscess.
Very few fistulae heal by themselves, which makes it necessary to use a surgery. Treating Fistula( Bhagandar ) has been complicated over the years because no treatment guarantees complete cure at once. Fistulectomy is a popularly used conventional Fistula( Bhagandar ) treatment and Ksharsutra Therapy is a traditional ayurvedic treatment, which is highly effective. VAAFT is a latest technology, video assisted Fistula( Bhagandar ) treatment in Pune, introduced by Dr. Ashwin Porwal at Healing Hands Clinic, the best Fistula( Bhagandar ) treatment center in Pune.( Now available at Chinchwad, Chakan and Opening soon at Navi Mumbai ) It is least invasive and assures negligible recurrence rate.