Free Medical Advice Related to Laparoscopic Surgery

Fistula Ano
Discussion in 'All Categories' started by Muskan - Sep 11th, 2012 6:17 am.
Muskan
Muskan
Dear Dr

My Name is Muskan, 40 years , Married having 3 years old boy. Working as Head of E banking Division for Hatton National Bank Sri Lanka


Anal Fistula

Did my first operation in 2010 Jan for abases in buttock at Apollo hospital in Colombo.
It was not successful 2nd Operation in May 2010.
Then I consulted another surgeon he said it is Fistula. He did the Fistula anatomy on 30th Nov 2011 using the Lift method ( Unfortunately I am the first patient for this new technique) .

I got infected then the inserted Seton on 6th Dec 2012. From that day on wards I am suffering from pain whilst passing the motion.

On 19th June 2012 they said it is abscesses did operation .
On 24 th June another operation performed send for ABST test.
On 29th June did big operation close to rectum for abscesses .
On 31st July only they found that I am having a Fistula track between buttock and rectum.

Inserted Cutting Seton on 4th Aug 2012. It is very painful whilst doing my day today work. Now taking Voltran 50 Mg every 8 hrs with Omniprosal.

Please provide me advise / solution without any further suffering.

I would like to go for VAAFT method which is relatively less pain for me or Anal Fistula Dr. Please advise on this. At this point with the Cutting Seton what are the possibilities of going for above methods or I should wait for drainage for couple of weeks ?. With your advice I can come and meet you Doctor at any time. I can come over there for further Fistula related latest examinations to find out the exact locations etc. Please Doctor provide me solution without any more suffering.

Please clarify with respective Dr , how many days I have to stay in India for post and pre operational procedure. Cost for operational procedure , Hospital charges, Dr Charges and any other charges. Please find out and e mail to me so that I can prepare myself. Most probably I will be in India first week of October 2012.
re: Fistula Ano by Sadhana Mishra - Sep 19th, 2012 11:01 am
#1
Sadhana Mishra
Sadhana Mishra
Dear Muskan

A fistula-in-ano is a hollow tract lined with granulation tissue, connecting a primary opening inside the anal canal to a secondary opening in the perianal skin. Secondary tracts may be multiple and can extend from the same primary opening.

The Parks classification system, demonstrated in the image below, defines 4 types of fistula-in-ano that result from cryptoglandular infections: intersphincteric, transsphincteric, suprasphincteric, and extrasphincteric.

Fistulotomy has to be done nicely. A probe is passed into the tract through the external and internal openings. The overlying skin, subcutaneous tissue, and internal sphincter muscle are divided with a knife or electrocautery, thereby opening the entire fibrous tract.

At low levels in the anus, the internal sphincter and subcutaneous external sphincter can be divided at right angles to the underlying fibers without affecting continence. This is not the case if the fistulotomy is performed anteriorly in female patients. If the fistula tract courses higher into the sphincter mechanism, seton placement should be performed. Curettage is performed to remove granulation tissue in the tract base.

The VAAFT (Video assisted anal fistula treatment)technique is performed for the surgical treatment of complex anal fistulas and their recurrences. Key points are the correct localization of the internal fistula opening under vision, the fistula treatment from inside, and the hermetic closure of the internal opening. This technique comprises two phases: a diagnostic one and an operative one. There is no need to know the fistula classification which obviously saves time and money. Moreover, surgical wounds in the perianal region are prevented and the risk of faecal incontinence is avoided because no sphincter damages are provoked.

We will perform this surgery for you once you will come to World Laparoscopy Hospital.

With regards
Sadhana
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