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Treatment of Anal Fistula Tract with Laser Ablation

A Sphincter Preserving Procedure for the fistula-in-ano management.

Anal Fistula

An anal fistula is a small tunnel that develops between the end of the bowel and the skin near the anus. They’re usually the result of an infection near the anus causing a collection of pus (abscess) in the nearby tissue. When the pus drains away, it can leave a small channel behind.

Anal fistula is an anorectal condition with over 90% of cases being cryptoglandular in origin and occurring after anorectal abscesses. Management of anal fistula (AF) remains challenging with many controversies. Anal incontinence and fistula relapse of anal fistula surgeons are fearful morbidities of surgeons. Many techniques for sphincter preservation such as internal sphincter fistula tract attachment, anorectal flap application, bioprosthetic plugs have been tried to come from above.

Despite the developments in the surgical field, the treatment of anal fistula is still a challenging problem, especially in complex, transsphincteric cases. The surgical treatment aims to avoid recurrences and also to preserve normal sphincter functions.

 

Laser Therapy for Sphincter Preservation

The laser applications was recently reported non-invasive technique in perianal fistulas for treatment and preserving anal sphincter function with a good success rate.

With the laser therapy, a new, particularly flexible laser fiber is introduced directly into the fistula tract and the fistula tissue is radiated radially from the inside. The light energy of the laser thus gently destroys the inflamed glandular tissue.

The laser probe is slowly pulled back step by step like a zipper, and the fistula is being closed. The highly flexible probe is suitable for the application even in wound tracts and can be applied independently from the length of the fistula tract.

The fistula tract collapses. This means that the fistula does not have to be removed by the surgeon during a major operation. The treatment is almost painless and convalescence noticeably shorter than with conventional surgical procedures.

The laser treatment takes only a few minutes and provides the possibility to completely spare the enucleation of the fistula out of the healthy tissue.

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