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Fistula: Fistulotomy

Surgery is the only means of curing fistulas and most commonly performed surgery is fistulotomy. An anal fistulotomy is done to open and drain a fistula allowing it to heal. The procedure is performed not only to repair and prevent the recurrence of the anal fistula but also to protect the sphincter muscles.

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Indication for Fistulotomy
Low fistula in ano
Fistulas that do not traverse the anal sphincter or puborectalis muscle
The procedure is performed under spinal or general anesthesia depending upon the number and location of fistulas. The surgeon first probes to find the fistula’s internal opening. This is followed by cutting, scraping and flushing of the infected tissue. The resultant wound is generally not closed and left open to heal of its own.In case of complicated fistulas, surgeon may remove or flatten some channels. Also some cases may require the procedure to be done in two or more stages depending upon the requirement of excision of sphincter muscle or if complete channel is not found.
Advantages of Fistulotomy:
Quick procedure
Shorter healing time
Decreased recurrence rate
Less chances of complications as compared to fistulectomy
What needs to be done after the surgery?
Take antibiotics, pain killers and stool softeners as prescribed by the physician
Change the gauze and bandages as described by physician
Regular sitz baths
Apply ice several times a day
Keep the area clean