Video-assisted anal fistula treatment VAAFT is a novel minimally invasive and sphincter-saving technique for treating complex fistulas. Karl Storz Video Equipment is used. Key steps are visualization of the fistula tract using the fistuloscope, correct localization of the internal fistula opening under direct vision, endoscopic treatment of the fistula and closure of the internal opening using a stapler or cutaneous-mucosal flap. Diagnostic fistuloscopy under irrigation is followed by an operative phase of fulguration of the fistula tract, closure of the internal opening and suture reinforcement with cyanoacrylate. No major complications occurred. In most cases, both short-term and long-term postoperative pain was acceptable.
Anal fistula: Intraoperative difficulties and unexpected findings
ASM / R / MRI of Perianal Fistulas in Crohn's Disease - EPOS™
Also known as anorectal fistula, a fistula in anus occurs spontaneously as a hollow cavity lined with granulation tissue. Cryptoglandular infections leading to perirectal abscesses are considered as the predominant cause of anorectal fistula. The resultant is an abnormal communication between the perianal skin and the anus. Anorectal fistulas can significantly affect the quality of life of an individual. For patients experiencing recurrent anorectal sepsis, therapeutic intervention is prescribed.
A new minimally invasive treatment for anal fistula
Anal fistula surgery is a commonly performed procedure. The diverse anatomy of anal fistulae and their proximity to anal sphincters make accurate preoperative diagnosis essential to avoid recurrence and fecal incontinence. Despite the fact that proper preoperative diagnosis can be reached in the majority of patients by simple clinical examination, endoanal ultrasound or magnetic resonance imaging, on many occasions, unexpected findings can be encountered during surgery that can make the operation difficult and correct decision-making crucial.
She specializes in laparoscopic colorectal surgery, using minimally invasive techniques to treat diseases of the colon, rectum and anus. Her areas of expertise also include inflammatory bowel diseases such as ulcerative colitis, Crohn's disease and pelvic floor disorders. Varma is also the Director of the UCSF Center for Pelvic Physiology, which evaluates patients with fecal incontinence, constipation, pelvic floor prolapse, rectal cancer and anal fistulas. She completed her residency in general surgery at UCSF and spent a year at the University of Minnesota to obtain specialized training in colon and rectal surgery. Her research interests include the assessment of clinical outcomes and quality of life for patients with colorectal cancer, inflammatory bowel diseases, and defecation disorders.