Video Assisted Anal Fistula Treatment, also known as VAAFT is so far the newest and most advanced surgical intervention introduced for Fistula-in-ano. This procedure is usually done under general anesthesia, where a tiny telescope is entered through the external opening of the site of the skin where the fistula-in-ano is located. The HD-camera of latest technology attached to the other end, thereby visualizes the inner aspect of the fistula pathway on a HD- monitor and the surgeon will remove the complete length of the fistula with the help of precise visualization up to its inner opening, located on the wall of the anal canal.

More importantly, this method can also detect abnormal branching patterns of the fistula tracts and carry on the necessary therapeutic techniques at the same time. After the complete removal of the fistula, the internal opening is closed with the help of either sutures or staplers, preventing the leakage of stools back in to the fistula tract and the entire canal is sealed off using a mild electric cautery. Some surgeons may also use fibrin or cynao-acrylate glue in order to obliterate the fistula pathway.

At the end gentle flushing of the wound with normal saline is done followed by a routine dressing at the site of fistula removal.

This method is highly encouraged, in order to clean dead tissue left inside the fistula tunnel so that it will result in a proper and quick healing.

What are the advantages of VAAFT:

• In this procedure, an incision is not made on the skin around the anus and therefore there is no visible scars unlike in other major surgeries.
• Being a camera guided and very precise procedure, no damage is caused to the muscles around the anus which are responsible in controlling bowel movements. As a result, possible adverse effects like bowel incontinence and leakage are highly unlikely when compared to other open surgeries done.
• Due to the minimal invasive nature of VAAFT and the lack of excisions, wounds or scar formation, the pain caused after the wearing off of anesthesia is very mild or negligible.
• Complete removal of the fistula is guaranteed since the whole procedure is being done under direct visualization of the canal. As a result of that, the incidence of recurrence is very rare.
• Since VAAFT is known to be a day surgery, patient will be discharged on the same day of the surgery after wearing off of anesthesia.
• Complete and quick healing of the wound will take place within a few days compared to that of a normal open surgery so patient can get back to his day to day life relatively in a short period of time.
• According to several research studies carried out, the technique of VAAFT has been accepted world-wide as a very efficient intervention made on fistula-in-ano, with a 100% success rate.
• More importantly, the cost of VAAFT is comparatively lower than what is expected for normal open surgery, so in patient’s point of view it is a huge benefit.