What is Fistula Surgery?

Comprehensive Guide to Fistula Surgery

Fistula surgery aims to treat an abnormal connection between tissues or organs, relieve symptoms and reduce the risk of recurrence. The particular surgical technique depends on where the fistula exists, its size, and its complexity.

The procedure depends on the type and location of the fistula and may involve draining infection, treating the tract or repairing affected tissues. Depending on the condition, surgeons may use tissue repair, advancement flaps or drainage procedures.

Let’s explore the different types of fistula surgeries, what to expect during the procedure, essential aftercare steps, and whether fistula surgery is covered by health insurance.
 

What are the Different Types of Fistula Surgery?

Surgeons select a procedure based on the fistula’s location, complexity and effect on surrounding tissues. Surgical elimination of the fistula focuses on protecting normal bodily functions and avoiding complications.

Check out the various types of fistula surgery below:
 

Fistulotomy

In a fistulotomy, the surgeon opens the anal fistula tract so it can heal from the inside out.

Seton Placement

When dealing with complex fistulas, doctors insert a surgical thread (seton) to manage pus drainage and improve healing as a preliminary step before final corrective surgical procedures.

Endorectal Advancement Flap

A flap of tissue from the rectal wall covers the fistula repair site while sparing more sphincter muscle from being cut.

LIFT (Ligation of Intersphincteric Fistula Tract)

The LIFT (Ligation of Intersphincteric Fistula Tract) procedure treats fistulas located between sphincter muscles while preserving muscle function.

Other Techniques

Unique treatments such as glues, plugs and clips serve to close the fistula in specific cases.

What to Expect During A Fistula Surgery?

Medical operations for treating fistulas differ based on where the abnormal connections are located and their level of complexity. The procedures for surgically treating different types of fistula follow individual treatment requirements that consider medical anaesthetics and recovery phases.

Fistulotomy

The time required for fistula surgery varies with the technique and complexity of the condition. A patient with small fistulas can usually have local anaesthesia, yet patients who need surgery for complex fistulas must receive general anaesthesia.

The surgeon creates a well-detailed cut to gain complete access to the fistula tract while it heals within its interior. This surgical method helps treat the abnormal opening by removing it and enabling regular tissue repair.

Seton Placement

The procedure of seton placement takes 30 minutes, but its time can be extended based on the case complexity. The type of anaesthesia depends on the procedure, patient and clinical circumstances. After the incision, the surgeon places a surgical loop inside the fistula track and secures the loop using a light dressing. The doctor may allow same-day hospital discharge for patients recovering well from the procedure.

The procedure demands several stages because surgeons may need to change or reinstate the seton during the recovery period. Postoperative surgical drainage from the fistula will persist for several weeks after completing the surgical procedures.
 

Colovesical Fistula Surgery

The surgical treatment for fistulas connecting the bladder and the sigmoid colon requires a sigmoid colectomy followed by segmental removal of the affected colon portions. During surgery, the medical professional fully handles the fistula before repairing both the bladder and the colon walls.

Treating colovesical fistulas is available as open surgery with one big incision or laparoscopic surgery using multiple small incisions. Length of hospital stay varies with the surgical approach, recovery and any complications.

What are the precautions to take after fistula surgery?

Successful healing and complication prevention require proper postoperative care following fistula surgery. Some of them are:

• Consuming a diet high in fibre while remaining well-hydrated helps patients generate softer stools, minimising the strain that endangers the surgical area.
• The surgical area requires regular cleaning with recommended medical methods and strict adherence to imposed activity limitations.
• In some cases, urinary catheters may be required until bladder healing is complete.
• During the recovery period, physicians usually recommend stool softeners to help patients avoid discomfort during bowel movements.
• Attend scheduled follow-up appointments and contact the care team promptly if you develop fever, worsening pain, unusual bleeding or discharge.

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