What Is Fistulectomy?
Fistulectomy is a surgical procedure used to treat an anal fistula. An anal fistula is a small tunnel that forms between the inside of the anus and the surrounding skin, usually caused by infection or abscess. These are among the most common causes of fistulectomy that lead patients to seek treatment.
During a fistulectomy procedure, the surgeon carefully removes the fistula tract to stop infection from spreading and to promote proper healing. This procedure helps relieve pain, discharge, and discomfort caused by the fistula.
Fistulectomy is considered a safe and effective treatment. It not only removes the fistula but also lowers the chances of it coming back. With proper post-surgery care, most people experience a smooth fistulectomy recovery and return to their normal routine in a few weeks.
Types of Fistulectomy Procedures
Fistulectomy is surgery to treat anal fistulas, and there are different types depending on how complicated the fistula is:
- Seton and Fistulectomy: For complex fistulas, a seton (thread or rubber band) is placed to drain the fistula. Later, the fistula is removed in stages.
- Excision and Primary Closure: For simple fistulas, the whole fistula is removed, and the wound is stitched closed.
- Flap Repair: For more complex fistulas, a piece of well tissue is used to cover the wound after removing the fistula to prevent incontinence.
- LIFT Procedure: Used for high fistulas, where the fistula tract is tied off and removed to avoid damaging important muscles.
- VAAFT (Video-Assisted): A minimally invasive method using a video camera to remove the fistula while causing less damage to surrounding tissues.
- Fistulotomy: For simple fistulas, the tract is cut open and left to heal naturally.
- Seton Fistulectomy: For complex fistulas, a seton is placed, and the tract is removed over time.
- Transanal Advancement Flap: For high fistulas, healthy tissue from the rectal wall is used to cover the wound after excising the fistula.
1 to 2 hours
Surgery Duration
General or Spinal Anesthesia
Anesthesia Used
1 to 2 days
Hospital Stay
4 to 6 weeks
Full Recovery Timeline
When is Fistulectomy Recommended?
A Fistulectomy indication is suggested when an anal fistula causes ongoing discomfort, infection, or complications that do not heal on their own. Here are the common situations where surgery is considered:
- Persistent Anal Fistula: If the fistula continues to cause pain, swelling, or discharge despite medication or other treatments, fistulectomy is advised for permanent relief.
- Recurrent Infections or Abscesses: Frequent abscess formation or pus discharge around the anus is a clear sign that surgical removal of the fistula tract is needed.
- Complex or Branching Fistulas: When the fistula has multiple tracts or affects deeper tissues, fistulectomy helps in complete removal and lowers the risk of recurrence.
- Impact on Daily Life: If the condition interferes with sitting, walking, hygiene, or overall comfort, surgery becomes the most effective solution.
Preparing for Fistulectomy Surgery Procedure
Preparing well before your fistulectomy ensures a safe surgery and smooth recovery. Here are the key steps:
Pre-Surgery Checkup
- Inform your doctor about your complete medical history, including previous illnesses, surgeries, and all medications you are currently taking. This helps the surgeon plan your procedure safely.
- Your doctor may suggest routine tests such as blood work or imaging. These tests confirm you are fit for surgery and help map the fistula tract for accurate treatment.
Healthy Habits Before Surgery
- Stop smoking at least 3-4 weeks before surgery. Smoking slows down healing and increases the chances of infection.
- Avoid alcohol and medicines like aspirin, blood thinners, or herbal supplements 1 to 2 weeks before surgery, as they can increase bleeding risks. Always check with your doctor before stopping prescribed medicines.
- Focus on a fiber-rich diet with fruits, vegetables, and whole grains. Drink plenty of water daily to maintain smooth bowel movements and reduce strain after surgery.
Home & Support Preparation
- Arrange for a family member or friend to accompany you on the day of surgery and drive you home safely afterward. You may also need help for the first day or two during recovery.
- Prepare your home with essentials such as a sitz bath for soothing care, soft cushions for sitting comfortably and all prescribed medicines within easy reach.
Surgery Day Guidelines
- Follow your doctor's fasting instructions carefully. Usually, no food or drink is allowed after midnight to reduce risks during anesthesia.
- Take a thorough bath the night before or morning of surgery and use antiseptic soap if your doctor recommends it. Avoid applying lotions, perfumes, or powders.
- On the day of surgery, wear loose, front-opening and comfortable clothing. Avoid jewellery, nail polish and makeup, as they may interfere with monitoring and care.
What Happens During Fistulectomy Surgery?
Fistulectomy is a surgical procedure done to remove an anal fistula and prevent repeated infections. The surgery is simple, safe, and designed to promote proper healing.
- Before Surgery: On the day of the procedure, you'll meet your surgical team to review the plan and clear any last questions. Anesthesia (general or spinal) is given so you remain comfortable and pain-free during surgery.
- Making the Incision: The surgeon carefully makes an incision along the fistula tract to fully access it. This step helps ensure that the entire tract is visible and can be treated without leaving behind infected tissue.
- Removing the Fistula: The complete fistula tract is removed along with any surrounding infected tissue. This lowers the risk of the fistula coming back and allows the wound to heal from the inside out. These are the key fistulectomy surgery steps that ensure complete removal.
- Cleaning and Stitching: The area is thoroughly cleaned, and depending on the depth and location, the wound may be stitched or left open to heal naturally. This decision is made to promote faster and safer recovery.
- After Surgery: Once the surgery is finished, dressings are applied, and you'll be moved to a recovery room. Most patients are encouraged to walk within a few hours. Sitz baths, pain management, and a fiber-rich diet are usually advised to support smooth healing.
Recovery After Fistulectomy Surgery Procedure
Fistulectomy recovery is a gradual process that requires proper care and attention. Following the right steps helps in faster healing and reduces the chances of complications.
- Immediate Recovery: After surgery, patients may experience mild pain, swelling, or discomfort around the wound. Pain-relief medicines are usually prescribed to manage this phase.
- Wound Care: Keeping the surgical site clean & dry is very important. Regular dressing changes as advised by the surgeon help in preventing infections.
- Diet and Hydration: Eating fiber-rich foods and drinking enough water makes bowel movements easier, which helps reduce strain on the healing wound.
- Activity and Rest: Avoid heavy lifting or strenuous physical activity during the first few weeks. Gentle walking is encouraged to maintain blood circulation.
- Healing Time: Complete healing may take a few weeks, depending on the size and depth of the fistula. Follow-up visits are essential to monitor progress.
- Return to Normal Life: Most people can return to their normal daily routine within 2-4 weeks, although recovery time can vary.
Benefits of Fistulectomy Surgery
Fistulectomy is an effective treatment for anal fistulas and offers long-term relief. Some key benefits include:
- Permanent Relief from Infection: Removes the fistula tract completely, reducing the risk of recurring abscesses or infections.
- Improved Comfort: Relieves pain, swelling and discharge, allowing patients to sit, walk and carry out daily activities without discomfort.
- Lower Risk of Recurrence: By removing the entire fistula, the chances of it coming back are greatly reduced.
- Faster Healing: Promotes natural healing from the inside out, supporting a smoother recovery process.
- Better Quality of Life: Restores hygiene, reduces embarrassment, and improves overall physical and emotional well-being.
Risks of Fistulectomy Surgery
Like any surgery, fistulectomy has some possible risks. While most people recover safely, it is important to be aware of potential fistulectomy complications:
- Bleeding or Infection: Some bleeding or wound infection can occur after surgery, though it is usually manageable with proper care.
- Pain or Discomfort: Mild to moderate pain is common during recovery but can be controlled with medication and sitz baths.
- Delayed Healing: In certain cases, the wound may take longer to heal, especially if the fistula was deep or complex.
- Recurrence of Fistula: There is a small chance that the fistula may come back, depending on its severity and type.
- Incontinence Risk (Rare): If the fistula is close to the anal muscles, there may be a slight risk of affecting bowel control, though this is uncommon.
What is the cost of fistulectomy surgery?
The cost of Fistulectomy Surgery typically varies depending on the severity of the fistula, the surgeon's expertise and the hospital facilities. At Medicover Hospitals, the surgery generally costs between Rs. 35,000 to Rs. 1,20,000.
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