Anal Fistula Treatment - Laser Surgery Procedure & Operation Benefits

What are the Benefits of Laser Anal Fistula Surgery?

A laser anal fistula surgery is a medically advanced and minimally invasive anorectal procedure that utilizes a laser beam to treat anal fistula. Some benefits that are associated with laser anal fistula surgery are given below:

• Minimally Invasive: As previously mentioned, laser anal fistula surgery utilizes a high-intensity, medical-grade laser to make small incisions and destroy the fistula tract. The high operating temperature of the laser also ensures minimal risk of bleeding and infection.

• Shorter Recovery: Due to its minimally invasive nature, recovery time after laser anal fistula surgery is significantly shorter compared to conventional methods. In most cases, recovery after laser anal fistula surgery 2 to 6 weeks. However, most patients are able to return to their normal lives and routines in just 1 to 2 weeks after surgery.

• Minimal Risk of Complications: The size of incisions made during a laser anal fistula surgery is extremely small. As a result, the chances of any complications, such as excessive bleeding or infection, are almost negligible. 

• Preservation of Surrounding Tissue: A laser anal fistula surgery is an extremely precise procedure. The incisions made during the procedure are very small when compared to traditional procedures and ensure maximum preservation of tissue surrounding the fistula. This results in shorter recovery time, negligible chance of complications, and better cosmetic results.
• Outpatient Surgery: A laser anal fistula surgery is usually performed on an outpatient basis and does not take more than 30 to 40 minutes to complete. Once the surgery is complete and there are no immediate complications, you will be allowed to go home on the same day of surgery.

How to Prepare Before Anal Fistula Surgery?

If you are planning to undergo an anal fistula surgery, it is better to be prepared before the surgery to avoid any complications during and after the surgery. 

1. Know everything about the procedure: Before the surgery, make sure to ask your doctor about the procedure, what to expect and preparation tips etc. 
2. Follow your surgeon’s instructions: Your surgeon will provide you with specific instructions to follow before your surgery. These may include dietary restrictions, restrictions on certain medications, and other guidelines to follow in the days leading up to your surgery. It’s important to follow these instructions to ensure a successful surgery and avoid any complications during the surgery. 
3. Arrange a companion: You will likely be given anesthesia during your surgery, which means you will not be able to drive yourself home afterward. Make sure to ensure someone is with you during your hospitalization and drives you back home after the procedure. 
4. Plan for recovery period: After your surgery, you will need time to rest and recover. Make sure to plan ahead for time off from work or other responsibilities to allow your body to heal properly.
5. Quit Smoking: Smoking can increase the chances of complications during the surgery and lowers your immune system, and may interrupt your healing process. It is always recommended to quit smoking as it is injurious to health. 
6. Stay hydrated: Drink plenty of water before the surgery to prevent constipation before the surgery. 
7. Inform your medical history: Inform your doctor beforehand if you are allergic to anesthesia or any kind of medicine. 

By following these steps, you can help ensure that you are fully prepared for a successful anal fistula surgery without any complications. 

How to Recover After Anal Fistula Surgery?

The recovery period may vary depending on the type of procedure used. Usually, non-surgical treatments like medications and home remedies take longer time to heal fistulas as compared to surgery. 

Medications

The duration of recovery for anal fistula with medications only varies depending on the severity of the condition. In most cases, it can take several weeks or even months to see significant improvement. It is important to follow your doctor’s recommended treatment plan and attend follow-up appointments to monitor progress. In some cases, surgical intervention is only the best treatment for anal fistula. 

Home remedies 

The duration of recovery from an anal fistula with home remedies varies from person to person. It typically takes anywhere from a few days to a few weeks for the fistula to heal completely. However, it is important to consult a healthcare professional before attempting any home remedies to ensure that the fistula is not a severe case that requires medical intervention.

Open surgery

The recovery time after open surgery for anal fistula varies depending on the severity of the condition. In general, it can take anywhere from 4 to 6 weeks to recover completely. During this time, patients may experience mild pain, swelling, and discomfort. It is important to follow all post-operative instructions provided by the doctor to ensure a smooth and successful recovery.

Laser surgery

The recovery time for anal fistula laser surgery depends on various factors such as the severity of the condition, the patient’s overall health, and adherence to post-operative care instructions. In general, patients can expect to take anywhere between two to six weeks to recover from the procedure fully. It is essential to follow the doctor’s advice and avoid activities that may hinder the healing process.

What to Expect After Anal Fistula Surgery?

Laser anal fistula surgery does not take more than 30 to 40 minutes to complete. It is also an outpatient surgery. This means that once the procedure is complete and there are no immediate complications, you will be able to go home on the same day of the procedure. Once the procedure is complete, you will be moved to a recovery area. Here, you will be kept under observation by your doctor. If there are any complications immediately after the surgery, your doctor will address them promptly.

After your anal fistula surgery, side effects such as bruising, minor bleeding, swelling, and bruising are to be expected and considered normal. These symptoms are not indicative of any complications and usually do not require any medical assistance. They should subside on their own.

To ensure a smooth recovery and minimize the chances of any postoperative complications as much as possible, your anorectal specialist will likely schedule some postoperative follow-ups. During these consultations, the urologist will examine the surgical site and make sure there are no signs of complications. These follow-up consultations are also a good opportunity for you to ask any questions you may have regarding the recovery and inform your proctologist if you have noticed any odd symptoms or persistent side effects during recovery.

Tips to Recover After Anal Fistula Surgery

Here are some general steps you can follow to boost your recovery after the anal fistula surgery.

1. Follow your doctor’s instructions: Your doctor will give you specific instructions on how to care for the wound after surgery. Follow these instructions carefully to prevent any complications and promote healing.
2. Take medicines on time: After surgery, you may experience mild pain and discomfort. Your doctor may prescribe over-the-counter medication to help you manage the pain. Make sure to take the medication as directed and inform your doctor if the pain persists or worsens.
3. Keep the wound clean and dry: It is crucial to keep the surgical wound clean and dry to prevent infection. Your doctor may give your some instructions on how to clean your surgical site. 
4. Avoid strenuous activity: Avoid strenuous activity for up to 1 week after the surgery. Strenuous activities can put pressure on the wound and slow down the healing process.
5. Eat a healthy diet: A healthy diet can help you recover faster after surgery. Include foods that are rich in vitamins and minerals such as fruits, vegetables, and lean proteins.
6. Attend follow-up appointments: Attend follow-up appointments with your doctor to monitor your progress and ensure that your wound is healing properly.
7. Stay hydrated: It is essential to stay hydrated after surgery. Drink plenty of water and avoid caffeinated and alcoholic beverages.

Recovering after anal fistula surgery requires patience and commitment. These steps will help you recover and get back to your daily routine in less time. 

What Lifestyle Changes Need to Make After Anal Fistula Treatment?

After undergoing surgery to treat anal fistula, there are certain lifestyle changes that you will need to make to ensure proper healing and to prevent future occurrences. 

Here are some important lifestyle modifications you should adopt after anal fistula surgery. 

Diet

It is important to maintain a healthy diet after surgery. You should eat foods that are high in fiber and avoid foods that are spicy or acidic. Drinking plenty of water will also help keep your digestive system functioning properly.

Hygiene 

Maintaining good hygiene is essential after anal fistula surgery. You should keep the area clean and dry and avoid using harsh soaps or other products that could irritate the skin. Taking regular baths or showers and using mild soap can help prevent infection.

Physical activity

After surgery, you should avoid strenuous physical activity until your doctor allows you to do so. Walking and light exercise are usually recommended, but you should avoid heavy lifting or activities that could put stress on the affected area.

Follow-up appointments

It is important to attend all follow-up appointments with your doctor after surgery. This will allow your doctor to monitor your healing progress and ensure that there are no complications.

Avoid constipation

Constipation can be a common problem after anal fistula surgery. To prevent this, you should eat a high-fiber diet, drink plenty of water, and avoid straining during bowel movements. Your doctor may also recommend stool softeners or laxatives to help keep your bowels regular.

Overall, it is important to follow your doctor’s instructions carefully after anal fistula surgery. By making certain lifestyle changes and taking proper care of yourself, you can ensure a successful recovery and prevent future occurrences of this painful condition. 

What are the Risks and Complications Associated with Laser Anal Fistula Surgery?

Like any other surgery, laser anal fistula surgery is also associated with some risks and complications, including;

1. Pain and Discomfort: Pain and discomfort are common after anal fistula surgery. The severity and duration of the pain depend on the type of surgery and the individual’s pain threshold. Pain can be managed with pain relief medication.
2. Infection: Infection is a common complication of anal fistula surgery. The wound can become infected if it is not kept clean and dry. Antibiotics may be prescribed to prevent or treat infection.
3. Bleeding: Bleeding after anal fistula surgery is rare but can occur. If the bleeding is excessive, it may require further medical attention.
4. Incontinence: Incontinence is a rare but severe complication of anal fistula surgery. It occurs when the sphincter muscles that control bowel movements are damaged during surgery. Incontinence can lead to fecal incontinence or the inability to control bowel movements.
5. Recurrence: Recurrence of the anal fistula is also a possibility after surgery. The recurrence rate is relatively low, but it may require further surgery to correct.
6. Fistula tract damage: Damaging the fistula tract during surgery is a potential risk. If the tract is not properly identified and treated, it can lead to further complications.
7. Allergic reactions: Allergic reactions to anesthesia or other medications used during surgery are possible. You should inform your doctor about ay allergies you may have before undergoing the procedure. 

Overall, anal fistula surgery is generally safe, but it does carry some risks and complications. You should be aware of these risks and discuss them with your doctor before undergoing the procedure. It is important to follow the doctor’s instructions for post-operative care to minimize the risk of complications.

What is the Cost of Anal Fistula Surgery?

The cost of anal fistula surgery may lie between the range of INR 45,000 to INR 60,000 in India. However, the final cost of anal fistula surgery may vary depending on various factors such as hospitalization charges, hospital choice, surgeon charges, anesthesiologist fee, type of anesthesia used, type of procedure, insurance coverage, the severity of the condition, cost of diagnostic tests etc.

Does Anal Fistula Surgery Covered Under Health Insurance?

Usually, anal fistula surgery is covered under insurance, but it is better to consult your insurance provider about the coverage of your insurance. 

If you have health insurance and choose Pristyn Care to get the treatment, our dedicated insurance team will help you in claiming your insurance on your behalf and make your treatment journey as easy as possible.

What Home Remedies are Beneficial for Anal Fistula?

Here are some home remedies that are beneficial in providing you relief from the often symptoms of anal fistula. 

• Ginger Tea: Ginger tea is a natural home remedy that may help alleviate the symptoms of anal fistula. Simply steep sliced ginger in hot water and drink as needed.
• Cloves: Cloves have been used for centuries as a natural remedy for anal fistula. Their anti-inflammatory properties can help reduce pain and swelling. To use, mix ground cloves with coconut oil and apply to the 2affected area. Repeat daily for best results.
• Tea Tree oil: Tea tree oil is a natural remedy that may help alleviate symptoms of an anal fistula. Its anti-inflammatory and antiseptic properties can reduce pain and swelling. However, it is important to consult with your doctor before using tea tree oil to treat an anal fistula.fistula
• Oregano leaves oil: Oregano leaves oil has been used as a natural remedy for anal fistulas. Its antibacterial properties can help reduce inflammation and promote healing.
• Turmeric milk: Turmeric milk is a natural remedy for anal fistula. To prepare, mix turmeric powder with warm milk and drink before bedtime.
• Sitz Bath: A sitz bath is a warm, shallow bath that can help relieve pain and discomfort associated with an anal fistula. It involves sitting in a basin of warm water for 15-20 minutes two to three times a day. Sitz bath can be very effective for anal fistula treatment.
• Use donut pillows: Donut pillows can be a helpful aid for those dealing with anal fistulas. These pillows have a round shape with a hole in the center, which can help relieve pressure and discomfort in the affected area. 
• Apple cider vinegar: Apple cider vinegar is a natural remedy for anal fistula due to its antibacterial properties. Dilute it with water and apply it to the affected area with a cotton ball. However, medical treatment may be necessary for a complete healing process. 
• Witch hazel: Witch hazel is a natural remedy that can be used to alleviate symptoms of anal fistula. It has anti-inflammatory properties and can reduce pain and swelling. Witch hazel can be applied topically to the affected area using a cotton ball. Consult your doctor before attempting to treat anal fistula with witch hazel.
• Aloe vera gel: Aloe vera gel can be used for anal fistula as it has anti-inflammatory and wound-healing properties. Apply a thin layer to the affected area daily.

Ointments (Creams) to Anal Fistula treatment

Here’s a list of the best ointments available in the to relieve the pain and discomfort associates with anal fistulas:

Shield Rectal Ointment

Sheild ointment is composed of allantoin, lidocaine, hydrocortisone acetate and zinc oxide. This ointment is very effective in relieving pain and discomfort associated with any anorectal condition. You can apply it 2-3 times a day. The cost of this ointment is INR 73 for 15g. 

Doctor Butler’s Ointment

This ointment gives immediate relief from anal burning and discomfort. This ointment is a combination of medical and herbal ingredients. The cost of doctor butler’s cream is INR 2458 for 28g.

Anovate cream

Anovate cream is a topical medication that contains a combination of ingredients, including a corticosteroid (lidocaine hydrochloride), an antibiotic (chloramphenicol), an antifungal (beclomethasone dipropionate), and an anesthetic (benzyl benzoate). It is primarily used for the treatment of various anal conditions, including hemorrhoids, anal f istulas,  anal fissures, or any other inflammation or itching in the naus. The cost of anovate cream is INR 97 for 20g. 

Lignocaine Gel

Lidocaine is the most commonly prescribed topical anesthetic for anal fistulas. It contains Alcuronium, Amphotericin B, Amprenavir etc. the cost of lignocaine gel is INR 30 for 10g. 

What are the Signs of a Healing Fistula?

Here are some symptoms to help you identify the signs of a healing fistula:

When a fistula is healing, you may notice signs indicative of improvement. Common signs of a healing fistula may include:

Decreased or resolved symptoms – As the fistula heals, you may experience lesser pain, swelling, tenderness, and discomfort in the anal area. 

Lesser discharge – The drainage or discharge from the fistula may also decrease or stop completely.

Healing infection – If an anal fistula heals, the signs of infection, such as redness, swelling, warmth, and pus formation, are likely to stop.

Improved bowel movements – Once the anal fistula starts healing, there will be improvement in the defecation or difficulty passing stool.

Don’t stop taking the prescribed medications once you notice these signs. Healing is a gradual process. It’s best to consult with your healthcare provider for proper evaluation and monitoring of your fistula’s healing progress.

What Happens if Anal Fistula Left Untreated?

An untreated fistula can cause various serious complications including:

• Fecal Incontinence: Chronic active or untreated perianal fistulas may lead to fecal incontinence. 
• Fistula drainage and abscess: An untreated anal fistula can lead to the formation of abscesses, which can be extremely painful.
• Sepsis: Sepsis is a life-threatening illness and the risk of developing sepsis increases if anal fistulas are left untreated.
• Peritonitis: Intestinal fistula may cause inflammation and infection of the peritoneum.
• Severe Infection: If left untreated, anal fistulas can lead to recurrent infections.
• Intense pain: Pus discharge and severe pain are common symptoms of an untreated, anal fistula.
• Anal Abscess: The risk of developing a fistula-related abscess increases if the condition is left untreated.
• Chronic wound: An untreated anal fistula may lead to the formation of a chronic wound, which can be difficult to heal.
• Surrounding destruction: If left untreated, anal fistulas can lead to the destruction of the surrounding tissues.
• Anal cancer: In rare cases, untreated anal fistulas can lead to the development of anal cancer.

What Foods You Should Eat If You Have An Anal Fistula?

If you have an anal fistula, it is important to take care of your diet to prevent further irritation and promote healing. 

Here are some foods that you should involve into your diet:

1. High-Fiber Foods: Eating high-fiber foods can help prevent constipation, which can worsen the symptoms of an anal fistula. Some examples of high-fiber foods include whole-grain bread, oats, fruits, vegetables, and beans.
2. Lean Protein: Protein is essential for repairing and building tissues in the body. Lean protein sources such as chicken, fish, and tofu can help with the healing process.
3. Probiotic-Rich Foods: Probiotics are good bacteria that can help maintain a healthy digestive system and prevent infections. Foods that are rich in probiotics include yogurt, buttermilk, apple, green peas, and cottage cheese etc.
4. Green Leafy Vegetables: Add green leafy vegetables in your diet, including cabbage, cauliflower, peas, broccoli, beans, bitter gourd, ridge gourd etc.
5. Omega-3 Fatty Acids: Omega-3 fatty acids help reduce inflammation in the body. Foods that are rich in omega-3s include fatty fish such as salmon, flaxseeds, chia seeds, and walnuts.

It is important to stay hydrated and drink plenty of juices and water to keep your digestive system healthy. You should avoid spicy and acidic foods, which can irritate your anal area and worsen fistula symptoms.

You can directly ask your doctor to provide you with a diet plan after the anal fistula surgery. 

What Foods You Should Avoid If You Have An Anal Fistula?

Some foods can aggravate the anal fistulas and make them worse. Here are some foods you should avoid if you have an anal fistula:

1. Spicy foods: Spicy foods can irritate the anal area and cause pain and discomfort. Avoid foods that contain chili, peppers, and other spices.
2. Dairy products: Dairy products can be difficult to digest and can cause constipation. Avoid fat-rich milk and cheese instead, you can take yogurt, cottage cheese, buttermilk etc.
3. Fried foods: Fried foods can be difficult to digest and can cause inflammation in the anal area. Avoid foods that are fried or deep-fried.
4. Alcohol and caffeine: Alcohol and caffeine can dehydrate the body and cause constipation. Limit your intake of alcohol and caffeine.
5. Processed foods: Processed foods contain additives and preservatives that can aggravate the anal area. Avoid processed foods like chips, cookies, and other snacks.
6. Red meat: Red meat can be difficult to digest and can cause constipation. Limit your intake of beef, pork, and other red meats.

It is important to eat a healthy and balanced diet if you have an anal fistula. Avoiding these foods can help prevent further irritation and discomfort. 

What is the Surgical Treatment for Anal Fistula?

There are various approaches to treating anal fistula, including:

1. Fistulotomy: Fistulotomy is a minimally invasive procedure to address anal fistulas. This procedure is usually performed under general anesthesia so you won’t be conscious during the procedure and may not feel pain and discomfort. During a fistulotomy, the surgeon opens up the fistula tract to expose the infected tunnel and clear it. You can return to your normal routine within 2-3 weeks after the procedure but complete recovery may take months. Overall, fistulotomy is an effective treatment option for anal fistulas, with a high success rate and low recurrence rate.

To better understand the fistulotomy procedure, here are the steps involved:

1. You will first be administered anesthesia to ensure you won’t experience any pain or discomfort.
2. The surgeon will then make an incision to open and lay the fistula tract flat.
3. Any abscesses or infectious material within the tract will be drained and cleaned.
4. Instead of stitching it up, the wound will be left open, allowing it to heal from the inside out, which decreases the chances of the fistula recurring.
5. Over time, with appropriate aftercare, the surgical site will heal and you’ll experience relief from symptoms.

The cost of fistulotomy may range between INR 25,000 to INR 60,000 in India.

2. LIFT (Ligation of Intersphincteric Fistula Tract): LIFT is a minimally invasive procedure to treat anal fistulas. This procedure is also performed on an outpatient procedure, meaning no hospitalization is required.  Most patients can return to their daily activities in about 2-3 weeks post-surgery, though full recovery may take over a few months. LIFT surgery has a high success rate and significantly reduces the chances of recurrence of anal fistula.

Here are the steps involved in the LIFT procedure.

1. You will first be given anesthesia, ensuring you don’t experience pain or discomfort during the process.
2. The surgeon will identify and access the intersphincteric tract between the internal and external sphincter muscles.
3. The fistula tract is then ligated, and the intersphincteric tract is cleared of any infectious fluid.
4. After the completion of the procedure, you will shifted to the recovery room to monitor the post-operative condition.
5. Then, you will get discharged once the anesthesia wears off.

The cost of the LIFT procedure in India lies between INR 30,500 to INR 86,950.

3. Seton placement: Seton placement is a technique where a surgical thread, often made of plastic or rubber, is positioned in the body to facilitate fluid drainage. Commonly utilized for draining abscesses or cysts, the procedure involves a minor incision through which the Seton is placed for drainage. This minimally invasive procedure is also done on an outpatient basis.

Here’s the breakdown of the seton placement process.

1. First of all, the doctor will sedate you with anesthesia to make you unconscious.
2. Then the surgeon will locate the fistula tract and thread the seton through it.
3. The Seton will then be tied outside the anus, ensuring continuous drainage and promoting healing.
4. Unlike some other procedures, the Seton will remain in place, gradually aiding the healing process and preventing the tract from closing prematurely.

The cost of seton placement in India lies between the range of INR 20,500 to INR 55,000.

4. Advancement flap procedure: The Advancement flap procedure is a surgical technique to treat complex anal fistulas. Typically, this procedure is carried out under general anesthesia, ensuring you remain unconscious throughout the procedure. You can resume your day-to-day activities in 2-3 weeks, although a full recovery can extend to a couple of months. The Advancement flap procedure has high success rates and it minimizes chances of recurrence.

Here are the steps of the advancement flap procedure.

1. You will be sedated under anesthesia.
2. Then the surgeon will create a flap from the rectal wall tissue.
3. This flap is used to cover the internal fistula opening, effectively blocking the tract.
4. The flap is stitched into place, ensuring it stays secure.
5. The surgical site will heal over time and you will get better.

The cost of advancement flap surgery in India lies between the range of INR 32,500 to INR 1,05,000.

Laser Surgery: Laser surgery is an advanced method to treat anal fistula. This is a minimally invasive procedure performed under local anesthesia. This procedure is performed on an outpatient basis, so you don’t have to stay in the hospital overnight. You may take around 4-6 weeks to recover after the anal fistula laser surgery. During this time, patients may experience mild pain, swelling, and discomfort, but the doctor may suggest over-the-counter medications to manage post-operative symptoms.

Here are the steps involved in the anal fistula laser surgery:

1. First, you will be administered local anesthesia to make you unconscious during the procedure.
2. Then, the surgeon will introduce a laser probe into the fistula tract.
3. Next, the surgeon use precise laser energy to close and seal the fistula.
4. The tract will gradually shrink and close due to the laser’s effect.
5. Over time, the wound will recover and you will start feeling better.

The cost of anal fistula laser surgery lies between the range of INR 30,000 to INR 90,000 in India.