Expert Fistula Surgery Specialist in Rohini, Delhi
Introduction
Fistula surgery, also referred to as fistulotomy or fistulectomy, is a specialized procedure aimed at treating anal fistulas—anomalies that create abnormal connections between the anal canal and the nearby skin around the anus. Anal fistulas can cause discomfort, swelling, and discharge, significantly impacting an individual’s daily life. At Dharamveer Solanki Hospital in Rohini, our dedicated team of medical professionals is committed to providing expert fistula treatment. Our experienced fistula surgery specialist employs advanced techniques to ensure optimal recovery and relief. If you’re seeking the best fistula doctor in Rohini, look no further. Book an appointment with us today for effective and personalized care.
Symptoms
Fistula-in-ano, also known as an anal fistula, is an abnormal connection between the anal canal and the skin surrounding the anus. Symptoms of a fistula-in-ano can include:
- Recurrent anal abscesses: An anal abscess is a painful, pus-filled swelling near the anus, which can be a precursor to the formation of a fistula.
- Persistent drainage: A fistula may cause continuous or intermittent discharge of pus, blood, or stool from the external opening near the anus.
- Pain and discomfort: The area around the fistula may be painful, particularly during bowel movements, sitting, or walking.
- Swelling and redness: The skin around the fistula may become red, swollen, and tender to the touch.
- Foul-smelling discharge: The discharge from the fistula may have an unpleasant odor.
- Irritation and itching: The constant discharge from the fistula can cause irritation and itching in the perianal area.
- Fever: In some cases, individuals with a fistula-in-ano may develop a fever, indicating the presence of an infection.
If you suspect that you or someone you know may have a fistula-in-ano, it is important to seek medical attention for a proper diagnosis and treatment.
If Fistula Surgery is Right for You: Factors to Consider
Individuals with the following conditions may require surgery for fistula:
- Anal fistulas causing pain, swelling, or discharge
- Fistulas that have not healed with conservative treatments, such as medication or drainage
- Recurrent infections or abscesses associated with the fistula
Types of Surgeries
There are several types of fistula surgery, including:
Fistulotomy:
A fistulotomy is a surgical procedure that involves opening the fistula tract, which is an abnormal tunnel-like connection between two body cavities or between a body cavity and the skin surface. In this procedure, the surgeon makes an incision along
the length of the fistula tract, exposing it and allowing it to heal from the inside out. The wound is usually left open, and new tissue gradually forms as the wound heals. Fistulotomy is commonly used to treat anal fistulas and has a high success rate. However, it may not be suitable for complex or high fistulas that involve a significant portion of the anal sphincter muscles, as this could lead to incontinence.
Fistulectomy:
In a fistulectomy, the surgeon removes the entire fistula tract rather than simply opening it. This procedure involves dissecting the tissue surrounding the fistula tract and excising it. The wound is then either closed with sutures or left open to heal naturally, depending on the specific circumstances. Fistulectomy is often used for more complex fistulas or when a fistulotomy is not feasible due to the risk of incontinence or other complications.
Seton placement:
Seton placement is a technique that involves placing a small, flexible tube, or seton, through the fistula tract. The seton is usually made of a soft, non-absorbable material such as silicone or nylon. The seton helps to promote drainage and healing by keeping the fistula tract open and allowing pus or other fluids to drain from the cavity. Seton placement may be used as a standalone treatment or in combination with other surgical procedures. It is often used for complex or high fistulas that involve a significant portion of the anal sphincter muscles, where a fistulotomy or fistulectomy may be inappropriate due to the risk of incontinence.
Advancement flap:
The advancement flap procedure is a surgical technique used to treat fistulas by covering the internal opening of the fistula with a flap of tissue. The flap is typically created from healthy, adjacent tissue, such as the rectal or anal mucosa. The surgeon carefully detaches the flap while preserving its blood supply and then advances it to
cover the internal opening of the fistula. The flap is then sutured in place, and the external opening of the fistula is either excised or left open to allow for drainage. The advancement flap procedure is often used for complex or high fistulas that involve a significant portion of the anal sphincter muscles, where a fistulotomy or fistulectomy may not be suitable due to the risk of incontinence. It may also be used when other surgical treatments have failed or are not appropriate.
Anaesthesia
Fistula surgery is usually performed under spinal anesthesia, or local anesthesia with sedation, depending on the type of surgery and the patient’s medical history.
What to Expect During Consultation?
During the consultation, the surgeon will:
- Discuss the patient’s medical history and symptoms
- Perform a physical examination, including a digital rectal exam and anoscopy
- Discuss the risks, benefits, and alternatives to fistula surgery
- Provide pre-operative instructions, including dietary restrictions, medications to avoid, and bowel preparation if necessary
FAQs
Fistula surgery typically takes 1 to 2 hours, depending on the type and complexity of the fistula.
Patients undergoing fistula surgery may be discharged the same day or after an overnight stay, depending on the type of surgery and the patient’s overall health.
Complications
Although fistula surgery is generally safe, complications can occur, such as: • Bleeding
- Infection
- Pain during bowel movements
- Anal stenosis (narrowing of the anal opening)
- Fecal incontinence (inability to control bowel movements)
- Recurrence of the fistula
- Anesthesia-related complications
Pre-op Evaluation
Before surgery, patients will undergo a pre-operative evaluation, including:
- Blood tests (e.g., complete blood count, coagulation profile, viral markers)
- Imaging studies (e.g., ultrasound, MRI) if necessary
- Electrocardiogram (ECG) to assess heart function
- Consultation with the anesthesiologist to discuss anesthesia options and risks
What Should I Expect During My Surgery Recovery?
After fistula surgery, patients can expect:
- Pain and discomfort managed with medications prescribed by the surgeon
- Gradual return to normal activities within 1-3 weeks, depending on the type of surgery
- Temporary dietary modifications, such as a high-fiber diet and increased water intake
- Sitz baths to promote healing and relieve discomfort
- Follow-up appointments to monitor recovery and ensure proper healing
What Results Should I Expect After Surgery?
Fistula surgery is effective in relieving pain, swelling, and discharge associated with anal fistulas. Most patients experience significant improvement in their symptoms after surgery. However, there is a risk of recurrence, which can be minimized by following the surgeon’s postoperative instructions and maintaining a high-fiber diet, drinking plenty of water, and avoiding straining during bowel movements.
Post-surgical Scars
Fistula surgery typically results in minimal scarring, as the incisions are made in the anal canal and rectum, which are not easily visible. Scarring may vary depending on the type of surgery and the patient’s individual healing process.
Pain Concern
Pain following fistula surgery is expected but can be managed with medications prescribed by the surgeon. Most patients experience significant improvement in pain within a few days after the procedure. Over-the-counter pain relievers or prescription medications may be recommended to control pain and discomfort during the recovery period.
Conclusion
Fistula surgery is a common and effective treatment for painful or bothersome anal fistulas that do not respond to conservative treatments. By understanding the process, risks, and recovery expectations, patients can make informed decisions about their treatment options and prepare for a successful surgery and recovery. Always consult with a qualified healthcare professional to discuss your specific situation and determine the best course of action for your condition.