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Treated complex fistula cases from around the globe
Center of excellence for proctology
World record holder of treating the most complex and longest fistula
Trained 500+ Fellow Surgeon for Laser Procedures
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An anal fistula is an infected passageway connecting the skin and the anus, the opening of the muscle at the end of the digestive tract. Typically caused by an infection of the anal glands that extends to the skin, symptoms include pain, swelling, and the discharge of blood and pus from the anus. Surgical intervention is usually required for the treatment of an anal fistula.
Indeed, addressing an anal fistula requires the expertise of a specialized doctor, commonly referred to as a colorectal surgeon or a proctologist. Given that the fistula does not heal spontaneously due to the presence of abscess and infection, prompt medical attention is crucial to prevent potential complications and the spread of the condition. Early initiation of treatment is key to a more favorable outcome.
An anal fistula (Bhagandar/Fistula in ano) is a small passage that forms between the anal (backside) and the skin surrounding the anal area. It is the result of a previous or existing anal abscess. The fistula comprises a tract with two openings—an internal opening leading into the rectum or anal canal and an external opening penetrating the skin of the buttocks.
The treatment of a fistula requires the expertise of a specialized medical professional known as a colorectal surgeon or a proctologist. A fistula may develop due to the abscess and infection and has the potential to spread, leading to additional complications. Therefore, early treatment is essential for a better prognosis.
A concise medical history followed by a clinical assessment, including a thorough rectal examination, constitutes the diagnostic process for an anal fistula. Simultaneously, a proctoscopy (a minor examination of the rectum using a small, tube-like instrument) is also conducted to assess any other conditions in the rectum.
In cases of complex fistulas where the tract is challenging to map, an MRI Fistulogram may be necessary for a comprehensive evaluation.
| Particulars | DLPL | Laser Procedure | Open Surgery |
|---|---|---|---|
| Cuts | Minimal | Minimal | Multiple |
| Scars / Stitches | Minimal | Minimal | Multiple |
| Incontinence | < 0.1 | Upto 40% | Upto 40% |
| Recurrence | < 0.1 | 7% - 40% | 7% - 40% |
| Painless Procedure | Yes | Yes | No |
| Blood Loss | Low | Low | High |
| Infection Chances | Low | Low | High |
| Hospital Stay | Quick Recovery | Quick Recovery | Bed Rest Required |
| Hospital Duration | Short | Short | Long |
| Technology | Most Advanced | Advanced | Outdated |
Fistula is a complex condition. The ultimate goal of any fistula treatment is not just to eliminate the current fistula but:
While most techniques like VAAFT, LIFT, FiLaC achieve the primary objective of closing the fistula and safeguarding the sphincter, they each come with varying rates of recurrence. Recognizing the challenges posed by fistulas, even a slight possibility of recurrence can be a significant concern for the patient.
Healing Hands Clinic, specializing in Proctology as a super specialty (a branch of surgery dealing with the rectum and gluteal region), has successfully treated numerous cases of fistula. Through years of treating fistula patients, we have sought to comprehend the intricacies of the disease and the factors contributing to recurrences. Through a comprehensive study and the application of knowledge and skills, we have developed a technique known as DLPL - Distal Laser Proximal Ligation.
In this procedure, the ulcer cavity is closed, and the opening is sealed, focusing on treating the distal part. The proximal portion of the fistula is then sealed using the Leonardo Laser. The radially emitting fiber of the laser applies energy to the fistula tract in a circumferential manner, ensuring complete closure of the fistula.
Healing Hands Clinic is renowned for its expertise in treating complex fistulas. Doctors from around the world often refer patients with intricate fistulas to Healing Hands Clinic. The team of surgeons at Healing Hands Clinic Gurugram, led by experienced professionals with over 10+ years in Proctology, specializes in addressing complex and recurrent cases of piles and fistulas. Patients receive recommendations for either FILAC or DLPL based on the grade and complexity of their condition.
Dr. Porwal, through an extensive study and the application of his knowledge and skills, has introduced a technique he named DLPL - Distal Laser Proximal Ligation. In this procedure, any abscess cavity, along with the internal opening, is initially excised. Subsequently, the distal tract is closed, and the proximal part of the fistula tract is sealed using the Leonardo Laser. The radially emitting fiber of the laser applies energy circumferentially to the fistula tract, ensuring complete closure.
Healing Hands Clinic released a series documenting 100 patients with complex high fistulas treated using DLPL. Notably, there was no instance of recurrence or incontinence in any of the cases.
It's akin to a brief nap! The only sensation you'll experience is a minor needle prick during the pre-procedure preparation. The complete surgery typically lasts around 30 minutes. At times, only the lower portion of your body is anesthetized, allowing you to remain awake and engage in conversation with your doctor!
Certainly, the laser probe is introduced into the fistula tract, and laser energy is administered in a circumferential manner to coagulate (burn) it. The tract undergoes healing through a process known as 'secondary intention.'
You can typically begin drinking water shortly after the procedure and eat whenever you feel hungry. Getting out of bed is possible within a few hours after surgery. It's normal to experience some pain after the procedure, but it can be easily managed with painkillers.
If your surgery is scheduled as a day care procedure, you can be discharged once the effects of the anesthesia have subsided, you have urinated, and you are comfortable with eating and drinking. As a general anesthetic is employed, it is recommended that a responsible adult accompanies you home and stays with you for 24 hours.
In some instances, you might be discharged after 24 hours, necessitating an overnight stay in the hospital. Before your discharge, you will receive guidance on post-operative care, pain management, and the use of laxatives.
A specific diet is not required. Simply ensure that you maintain a healthy, fiber-rich diet both before and after the surgery.
Ensure you get ample rest, take a Sitz bath approximately three times daily (especially after a bowel movement), uphold personal hygiene, and incorporate a fiber-rich diet.
You can commence traveling one week after the procedure.
Fever exceeding 101 degrees Fahrenheit,
Pain unresponsive to prescribed medications,
Unusual bleeding during bowel movements,
Persistent nausea or vomiting.
Healing Hands Clinic,
Spaze ITech Park Tower C, Ground Floor, Unit no 06, 07 and 08 Sohna road, Sector 49, Gurugram, Haryana 122018.
Healing Hands Clinic,
1st Floor Sheetla Chamber, Old Delhi Road, Opposite Air Force School, Sector 14, Gurugram, Harayana 122002.
CALL : +91 8792498991
