February 14, 2012
School of Medicine, Kochi
Video Assisted Anal Fistula Treatment (VAAFT) is a novel surgical technique for the treatment of anal fistulas. Fistulas are abnormal passages with external and internal openings, and a tract connecting the two.
“Traditionally treatment of fistulas was associated with failure and pain. The internal openings and side tracts were often missed causing recurrence,” shared Dr. Riju R. Menon, Associate Professor in the Department of General Surgery of the Amrita School of Medicine.
Dr. Riju recently successfully led a VAAFT surgery for a 23-year-old patient diagnosed with anal fistula with the assistance of Drs. Shivashankaran, Shaaz, Bipin and Jithendra.
VAAFT is a painless, yet effective method for treating complex fistulas and preventing their recurrence. Dr. P. Meinero in Italy is credited with performing the first such procedure world-wide.
The conventional treatment for anal fistula sometimes results in faecal incontinence which causes extreme discomfort to the patient. The resultant wound from fistula surgery takes anywhere between six weeks to three months to heal.
“We wanted a more effective and painless solution for fistula treatment; hence VAAFT was our choice,” stated Dr. Riju.
Explaining the procedure in detail, he also listed benefits over conventional treatments such as fistulectomy and fistulotomy.
“Since VAAFT uses a fistuloscope for visualizing the entire length of the tract, there is no need to do a fistulogram to make out the internal opening.”
“The fistuloscope is passed through the external opening. The entire length of the tract is made out including side branches of the fistula, if any. The unhealthy tissue inside the fistula is cauterized and the internal opening is then closed using a cutting linear stapler.”
“A glue is injected inside the fistula to doubly ensure closure of the internal opening and the whole fistula.”
“There are no wounds and there is no need for multiple dressing changes. In addition, the pain caused is minimal. The surgeon can also assure complete closure of the fistula since the entire tract is visualized from inside.”
“Postoperative recovery is quick, and the patient can return to work the next day itself.”