Anal Fistula Treatment - Laser Surgery Procedure & Operation Benefits

Prompt treatment for anal fistula is vital as it does not heal on its own. At HeptaCare Health , you can get treatment for anal fistula from specialized doctors with facilities like advanced laser treatments, medical care coordinators, and post-surgery care.

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What is Anal Fistula?

An anal fistula is an abnormal connection or tunnel that forms between the anal canal (the end portion of the digestive tract) and the skin around the anus. It typically develops as a result of an infection or an abscess (a collection of pus) in the anal glands, which are small glands located near the anus.

Anal fistulas can cause various symptoms, including persistent pain and discomfort around the anus, swelling, redness, tenderness, and the presence of discharge or pus. Other symptoms may include itching, fever, and general malaise. 

What are the Types of Anal Fistula?

There are several types of anal fistulas, classified based on their location and severity.

Intersphincteric Fistula: This type occurs between the internal and external sphincter muscles of the anus. It’s the most common type and usually results from an infected anal gland.
Transsphincteric Fistula: This fistula passes through both the internal and external sphincter muscles. An abscess infection typically causes it.
Suprasphincteric Fistula: This fistula extends above the internal sphincter muscle and often stems from a spreading abscess infection.
Extrasphincteric Fistula: This type goes beyond the external sphincter muscle and usually develops from a chronic infection.

You should seek medical attention if you suspect an anal fistula, as it can cause discomfort and lead to complications if left untreated.

Causes of Recurrence:

A successful laser anal fistula surgery means the anal wound heals completely without leaving any residual tract, external openings, or perianal discharge.

Doctors often recommend laser surgery as the most effective treatment for anal fistulas. However, the condition may still return after surgery for several reasons. Here are some common causes of recurrence:

Poor Hygiene of the Surgical Site: Failing to keep the surgical area clean exposes it to harmful bacteria and germs. This contamination can lead to infections and may prevent proper healing of the fistula. Therefore, it’s essential to maintain hygiene around the anal wound after surgery.

Failure to Follow Postoperative Instructions: Your anorectal specialist will provide specific guidelines for recovery. Following these instructions carefully can help prevent complications. Ignoring them may delay healing and increase the risk of recurrence.

Ongoing Preoperative Risk Factors: Surgery alone may not be enough to prevent recurrence. If you don’t address the lifestyle factors that caused the fistula initially, it might return and require further treatment.

How is Anal Fistula Diagnosed?

An anal fistula is a medical condition characterized by an abnormal tunnel connecting the anal canal to the skin surrounding the anus. The diagnosis of anal fistula typically involves a physical examination and a review of the patient’s medical history. 

During the physical examination, the doctor will perform a visual analysis of the anus and surrounding area to look for any signs of inflammation, swelling, or discharge.

The doctor may also perform a digital rectal exam to check for the presence of any abscesses. The doctor may order additional tests to confirm the diagnosis, such as an MRI or a fistulogram, which involves injecting a dye into the anal fistula to help identify its exact location and extent. 

It is important to seek medical attention if you suspect you may have an anal fistula, as early diagnosis and treatment can help prevent complications and improve outcomes.

What are the Treatment Options Available for Anal Fistula?

There are two approaches to treating anal fistula, i.e. surgical or non-surgical. 

Here are some surgical treatment approaches for anal fistula. 

Fistulotomy

Fistulotomy is a surgical procedure used to treat anal fistulas. The procedure involves cutting the fistula and removing the infected tissue. The goal of the surgery is to drain the abscess and prevent recurrence. A fistulotomy is typically performed under general anesthesia and can be done as an outpatient procedure.

Recovery time varies but typically takes a few weeks. Complications can include bleeding, infection, and fecal incontinence. Overall, fistulotomy is an effective treatment option for anal fistulas, with a high success rate and low recurrence rate.

LIFT (Ligation of Intersphincteric Fistula Tract)

This surgical technique involves tying the fistula tract near the internal anal sphincter muscle. The LIFT procedure involves making an incision in the skin near the fistula and then using a special tool to locate the internal opening of the fistula. The internal opening is then closed off with a suture, which helps to prevent the fistula from recurring.

The LIFT procedure is generally considered to be a safe and effective treatment for anal fistulas, with a low risk of complications. However, it may not be suitable for all patients, and the decision to undergo the procedure should be made in consultation with a qualified healthcare provider.

Seton placement

Seton placement refers to a medical procedure where a doctor places a small piece of plastic or rubber inside the body to help drain fluids. Doctors commonly use this technique to drain abscesses, cysts, or other fluid collections. During the procedure, the doctor makes a small incision and inserts the Seton under the skin.

After insertion, they tie the Seton to form a loop that allows for continuous drainage. Since the procedure is minimally invasive, doctors often perform it in an outpatient setting. Most patients experience minimal risks or complications. Proper post-procedure care helps ensure successful healing.

Advancement flap procedure

The advancement flap procedure is a surgical technique used to repair defects or wounds in the skin. This method involves cutting a flap of skin adjacent to the wound and advancing it across the defect, closing the wound.

The procedure is commonly used for reconstructive surgery in areas such as the face, neck, and hands. Advancement flaps are a reliable and effective way to repair skin defects caused by trauma, cancer, or congenital malformations.

The procedure is usually performed under local anesthesia and can be completed in an outpatient setting, with patients typically returning to normal activities in a few days.

Laser surgery

During laser surgery for anal fistula, the patient is typically placed under anesthesia. A small probe is then inserted into the fistula tract, guided by an endoscope or other imaging techniques.

The laser energy is delivered through the probe, targeting and destroying the tissues along the fistula tract. The laser energy effectively seals off the fistula tract by creating a controlled thermal injury.

Non-Surgical Treatments For Anal Fistula

Fibrin glue injection

This is an endoscopic procedure where fibrin glue is injected into the fistula tract to seal it and reduce any risk of infection or recurrence. This procedure can often be done without any incisions being made, which makes it less invasive than other surgical treatments for anal fistulas.

It is important to note that non-surgical treatment is not a recommendable option, as a fistula rarely heals without surgical intervention. Surgery is always the best treatment for anal fistula.

What are the Benefits of Laser Anal Fistula Surgery?

Benefits of Laser Anal Fistula Surgery
  1. Minimally Invasive
    The surgeon makes small incisions and uses a high-intensity, medical-grade laser to destroy the fistula tract. The laser’s high operating temperature minimizes bleeding and infection risks.

  2. Shorter Recovery
    Because this procedure remains minimally invasive, most patients recover within 2–6 weeks. Many resume normal activities in just 1–2 weeks.

  3. Fewer Complications
    Small incisions virtually eliminate excessive bleeding and infection.

  4. Tissue Preservation
    Precise laser cuts spare surrounding tissue, which speeds healing, reduces complications, and improves cosmetic results.

  5. Outpatient Procedure
    Surgeons complete the procedure in 30–40 minutes. Patients leave the same day once the team confirms there are no immediate complications.

Preparing for Surgery
  • Learn the Procedure: Ask your doctor what to expect and how to prepare.

  • Follow Instructions: Adhere to dietary restrictions, medication guidelines, and other preoperative advice from your surgeon.

  • Arrange Transportation: Because anesthesia prevents you from driving, have a companion drive you home.

  • Plan Recovery Time: Request time off work and clear obligations to rest.

  • Quit Smoking: Smoking impairs healing and raises complication risks.

  • Stay Hydrated: Drink plenty of water to prevent preoperative constipation.

  • Share Your Medical History: Tell your doctor about any allergies or prior reactions to anesthesia.

Recovery After Surgery

Timeline

  • Laser Surgery: Expect 2–6 weeks to heal fully. Follow your doctor’s postoperative care plan.

  • Open Surgery: Typically takes 4–6 weeks to recover.

  • Medications & Home Remedies: Recovery varies; you may need several weeks or months. Consult your physician before starting home treatments.

What to Expect

  • You will rest in a recovery area under observation immediately after surgery.

  • Minor bruising, swelling, or bleeding may occur but usually resolves on its own.

  • Schedule follow-up visits so your surgeon can monitor healing and address concerns.

Recovery Tips

  1. Follow all postoperative instructions.

  2. Take prescribed medications on schedule.

  3. Keep the wound clean and dry.

  4. Avoid strenuous activities for at least one week.

  5. Eat a balanced diet rich in vitamins and lean proteins.

  6. Stay hydrated and avoid alcohol or caffeine.

  7. Attend all follow-up appointments.

Lifestyle Adjustments
  • Diet: Eat high-fiber foods (whole grains, fruits, vegetables) and lean proteins. Drink plenty of fluids.

  • Hygiene: Use mild soap and keep the area clean and dry. Sitz baths (15–20 minutes, 2–3 times daily) soothe discomfort.

  • Activity: Resume light exercise like walking, but avoid heavy lifting until cleared by your doctor.

  • Bowel Health: Prevent constipation with fiber, fluids, and stool softeners if needed.

Risks and Complications

Although generally safe, any surgery carries risks:

  • Pain and Discomfort

  • Infection

  • Bleeding

  • Incontinence (rare)

  • Recurrence of the Fistula

  • Allergic Reactions to anesthesia or medications

Discuss these risks with your surgeon and follow postoperative care guidelines to minimize complications.

Cost and Insurance
  • Cost Range in India: Laser surgery typically costs between INR 25,000 and INR 60,000, depending on hospital fees, surgeon fees, anesthesia, and diagnostic tests.

  • Insurance: Most health plans cover anal fistula surgery. Consult your provider and, if needed, enlist HeptaCare Health’s insurance team to assist with claims.

Home Remedies (Adjunctive)

Consult your doctor before using any of these

  • Sitz Baths: Warm water baths relieve discomfort.

  • Ginger Tea: Steep sliced ginger in hot water to reduce inflammation.

  • Turmeric Milk: Mix turmeric powder with warm milk to leverage its anti-inflammatory properties.

  • Topical Oils: Apply diluted tea tree or oregano oil for their antiseptic effects.

  • Aloe Vera: Use gel topically to soothe and promote healing.

Signs of Healing
  • Decreased pain and swelling

  • Reduced or no discharge

  • Improved bowel movements

  • Absence of infection signs (redness, warmth, pus)

If symptoms persist or worsen, contact your healthcare provider promptly.

Consequences of Untreated Anal Fistula

Leaving a fistula untreated can lead to chronic abscesses, sepsis, peritonitis, fecal incontinence, chronic wounds, and—rarely—anal cancer. Seek treatment early to avoid severe complications.

Surgical Options Beyond Laser
  1. Fistulotomy (INR 25,000–60,000)

  2. LIFT Procedure (INR 30,500–86,950)

  3. Seton Placement (INR 20,500–55,000)

  4. Advancement Flap (INR 32,500–105,000)

Each procedure carries unique benefits and recovery timelines. Discuss the best choice with your surgeon.

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