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ORIGINAL ARTICLE
Year : 2019  |  Volume : 16  |  Issue : 4  |  Page : 267-270

Video-assisted anal fistula treatment in the management of fistula-in-ano: A 3-year experience


1 Department of Surgery, Hilla Teaching Hospital, Babil Health Directorate, Babylon Province, Iraq
2 Department of Surgery, Babylon Province, Al-Imam Alsadequ General Teaching Hospital, Babil Health Directorate, Babylon Province, Iraq

Correspondence Address:
Dr. Mohammed Salih Al-Janabi
Department of Surgery, Hilla Teaching Hospital, Babil Health Directorate, Babylon Province
Iraq
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/MJBL.MJBL_79_19

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Background: Fistula-in-ano and especially the high and complicated type is still one of the difficult surgical problems to solve. The new promising technique, video-assisted anal fistula treatment (VAAFT) was done first by Professor P. Meinero in 2006. Objective: The objective of the study was to describe the technique and the encouraging result of VAAFT. Materials and Methods: Using Karl Storz Company fistuloscope, 200 patients with anal fistulas were treated in Babylon Private Hospital in Al Hilla (Center of Babylon Governorate). This was done in two phases: diagnostic phase including visualization of fistula tract and identification of internal opening, followed by the operative phase by cauterization, curettage of the tract, irrigation using 1% mannitol solution, and closure of the internal opening using no. 1 Vicryl (polyglactin). Results: From the 200 patients with anal fistulas, 40 patients (20%) had undergone classical fistula surgery. No major complications were recorded. Early and late postoperative pain and discomfort were mild. The cases followed up at 6 weeks and 3 months postoperatively. Primary healing rate was 70% at 12 weeks and 74% at 3-month follow-up. The overall healing rate percent after 1 year was 80%. Conclusion: VAAFT is a safe, sphincter-saving, painless procedure and can be done as a day case with promising preliminary results, and we can repeat the treatment till cure is achieved.


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