VAAFT is by far the newest and the most advanced surgical intervention for anal fistula.
What is an Anal Fistula?
An anal fistula is an abnormal tract which has a primary opening inside the anal canal and secondary opening in the perianal skin. It’s painful and also causes bleeding and discharge. It occurs most commonly after surgery to drain an abscess. Sometimes anal fistula leads to persistent drainage, and in case the outside opening of the fistula closes it, it can lead to a recurrent anal abscess. Surgery is the only treatment for a fistula.
Symptoms of an Anal Fistula are:
- Continuous throbbing pain making it difficult for the person to sit.
- Swelling, redness, tenderness, and irritation of the skin around the anus.
- Discharge of blood or pus.
- Constipation and pain while passing stool.
- Perianal abscess causing fever.
If ignored a complex fistula-in-ano develops, and the patient might complain of stool and gas passing through the fistula.
There are various procedures to treat anal fistula such as surgery and fistulectomy (involving the removal of complete fistula). These treatments are painful and require hospitalization and daily dressing. They also take a long time to heal and the chances of reoccurrence are high.
VAAFT surgery, on the other hand, is a painless procedure, requires no incision and the patients recover faster.
What is VAAFT (Video-Assisted Anal Fistula Treatment)?
VAAFT or Video-assisted anal fistula treatment is a new, non-surgical and painless procedure to treat the anal fistula. This procedure also helps the patient to recover faster and cuts down the chances of reoccurrence. Being a painless treatment the patient does not face problem in bowel movement after the VAAFT procedure is done, as happens in the case of other surgeries involved in the anal fistula treatment.
How is VAAFT Procedure Done ?
The VAAFT or Video-assisted anal fistula treatment Procedure Requires:
- A video telescope which allows the surgeon to look inside the fistula tract.
- A unipolar electrode for diathermy of the internal tract. It is connected to a high-frequency electrode.
- A fistula brush and forceps to clean the tract and any granulation tissue.
- Before the VAAFT procedure, the patient is given anesthesia and is made to lie in a lithotomy position.
VAAFT is done in 2 phases:
- Diagnostic phase
- Operative phase
In the diagnostic phase of VAAFT procedure, the fistuloscope is inserted into the fistula to locate the anal opening and look for the secondary tract or any abscess cavity. The anal canal is kept open using a speculum. An irrigation solution is used to give a clear view of the fistula tract. The light of fistuloscope is seen on the internal opening of the fistula. This helps locate the internal opening.
In the operative phase of VAAFT procedure, the fistula tract is cleaned and the internal opening is closed using stitches and staples. This is done with the unipolar electrodes under the guidance of the video. The necrotic material is removed by continuous irrigation and using fistula brush and forceps.
- VAAFT technique is a sphincter-saving procedure, as the wounds are extremely small.(2)
- Advantages of VAAFT or Video-Assisted Anal Fistula Treatment
- VAAFT is a non-invasive procedure. There are no cuts on the skin around the anus and no large wounds as in surgery.
- There is lesser pain after the VAAFT procedure as it does not involve large cuts and wounds.
- The patient does not lose control over bowel movements because VAAFT procedure does not harm the muscle around the anus.(1)
- There is complete removal of the tract of the fistula which means that the whole fistula-in-ano disease is removed. This makes the chances of reoccurrence minimal.
- The patient sufferings are minimized with VAAFT procedure as there is rapid and complete healing within a few days.
Following VAAFT procedure, the Patient recovers faster and can resume work early.
The Video-assisted anal fistula treatment procedure is low in cost as the cost of after surgery medications and dressing are highly reduced. The results are excellent.
Disadvantages of VAAFT or Video-Assisted Anal Fistula Treatment Procedure
- Risk of reoccurrence which leads to a risk of recurrent surgeries.
- Risk of reopening of the internal opening of the fistula.