Pilot study of video assisted anal fistula treatment

Published Date: 19th July 2016

Publication Authors: Ormsby N, Rajaganeshan R

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Abstract

Introduction Video-assisted anal fistula treatment (VAAFT) is a minimally invasive, sphincter-preserving procedure with low morbidity. It was the aim of this prospective study to analyse both the feasibility and preliminary results of video-assisted anal fistula treatment (VAAFT) combined with advancement flap repair for anal fistula.

Method 

The procedure involves diagnostic fistuloscopy and visualisation of the internal opening, followed by fulguration of the fistulous tract and closure of the internal opening with suture ligation. The video equipment (Karl Storz, Tuttlingen, Germany) was connected to an illuminating source.

Results 

The study was conducted from October 2014 to February 2015. Twelve patients with transsphincteric fistula were operated on with VAAFT and were followed up according to the study protocol. No major complications occurred. In most cases, both short-term and long-term postoperative pain was acceptable. Primary healing was achieved in 9/9 (100%) within 3 months of the operation. The other 3 patients are still awaiting follow up.

Conclusion 

VAAFT is a minimally invasive procedure performed under direct visualisation. It enables visualisation of the internal opening and secondary branches or abscess cavities. It is a sphincter-saving procedure and offers many advantages to patients. Our initial results with the procedure are quite promising.

Joshi, HM; Ormsby, N; Rajaganeshan, R. (2015). PTU-234 Pilot study of video assisted anal fistula treatment in a district general hospital​ . Gut. 64 (Suppl 1), A165

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