Vaaft treatment at srm mch&rc
Fistula-in-ano, or perianal fistula is plagued with recurrences, necessitating multiple hospital admissions for patients suffering from unrelenting pain and discharge from the perianal region. The usual treatment is an open fistulectomy or fistulotomy procedures, with the wound laid open in the perianal region, which takes time to heal, thereby delaying normal life for the patient. Further, there is the risk of these procedures causing damage to faecal continence.
With these in mind, the surgeon at the SRM Medical College Hospital and Research Centre (SRM MCH&RC) in Kattankulathur have attempted to do a Video Assisted Anal Fistula Treatment (VAAFT) for the patients. This novel technique, developed in 2006, is gaining popularity all around the world.
The first patient was a 25-year-old male who came to the OPD with complaints of perianal discharge. Appropriate investigations were done which confirmed diagnosis of Fistula-in-Ano. He was successfully treated with VAAFT, and was discharged the next day as he had minimal post-operative pain, there was no open wound, and there were no major complaints. When reviewed a week later, his wound had healed and there were continence issues. He was able to return to normal routine promptly.
“We have so far done five cases of VAAFT with a high-level of patient satisfaction,” said Pro Vice Chancellor of Medical and Health Sciences Lt Col Dr A Ravikumar.
He adds that they have been able to visualise the entire fistulous tract through a fistuloscope, which is then coagulated with electrocautery, scraped and washed with glycine. “The external opening is excised and the wound is closed with absorbable sutures. This ensures patients have only minimal post-operative pain.” Ravikumar said.
With the VAAFT delivering such encouraging results, the surgeons at SRM Hospital are trying to employ caudal anesthesia and also post-operative analgesic blocks, which may allow the patients to be discharged on the same day of the surgery (day case surgery), making the process even more comfortable for them.