Surgery for Anal fistula

Surgery for Anal fistula is done to treat an infected tunnel that develops between the skin and the muscular opening at the end of the digestive tract.

Some facts about Anal fistula:

Preparation for Anal fistula Surgery:

• Avoid eating and drinking anything eight hours before Anal fistula Surgery.
• You are allowed to drink a sip of water with your medications if needed.
• Any history of bleeding disorders or taking any blood-thinning  medicines, aspirin, or other medicines that affect blood clotting should be informed to your doctor as you may need to stop taking these medicines before your surgery.
• The possible complications and side effects, the risks, and what the operation involves  will be discussed with you by your doctor.
• Mapping the fistula tract can be done by a MRI which also provide detailed images of the sphincter muscle and other structures of the pelvic floor.
• High-frequency sound waves are used by Endoscopic ultrasound  to identify the fistula, the sphincter muscles and surrounding tissues.
• An X-ray of the fistula after a contrast solution is injected can be done which is known as Fistulography.

Procedure for Anal fistula Surgery:

• Treatment of anal fistula depends on the  location and complexity of fistula.
• The aim o surgery is to repair the anal fistula completely to prevent recurrence and to protect the sphincter muscles as damage to these muscles can lead to fecal incontinence.
• The surgeon will cut the  internal opening of the fistula, scrapes and flushes out the infected tissue, and then flattens the channel and stitches it in place in case of a Fistulotomy.
• The surgeon may need to remove some of the channel to treat a more complicated fistula.
• Fistulotomy may be done in two stages if the entire channel can't be found or a significant amount of sphincter muscle must be cut.
• A flap from the rectal wall may be created by the surgeon before removing the fistula's internal opening in case of advancement rectal flap.
• The repair is covered by using the flap.
• The amount of sphincter muscle that is cut can be reduced by this procedure.
• A silk or latex string (seton) will be placed by the surgeon into the fistula to help drain the infection in case of Seton placement.
• The surgeon will clear the channel and stitches shut the internal opening in Fibrin glue and collagen plug.
• Special glue made from a fibrous protein (fibrin) will be injected through the external opening of fistula.
• The anal fistula tract will be sealed with a plug of collagen protein and then closed.