Best Fistulectomy Surgery in Delhi, India

Fistulectomy is a surgical procedure to remove an abnormal connection, or fistula, between two body parts. A fistula is an abnormal passageway that connects two organs or vessels that do not normally connect. They can result from infections, inflammations, or surgeries and may lead to significant discomfort and medical complications. 

Fistulas can develop in various parts of the body, but are most commonly found in the digestive tract, urinary tract, and between blood vessels. The procedure aims to completely remove the fistula tract, and is crucial for resolving the symptoms and complications associated with fistulas, thereby restoring normal function and relieving symptoms.

Types of Fistulectomy

Depending on the location and type of fistula, different surgical techniques may be employed:

• Anal Fistulectomy: This procedure specifically targets fistulas in the anal region, often resulting from conditions like anal abscesses or Crohn’s disease. It involves the careful removal of the fistula to prevent recurrence and promote healing.
• Enterocutaneous Fistulectomy: This surgery addresses fistulas connecting the intestine to the skin, which can occur after abdominal surgeries or due to inflammatory bowel diseases. The procedure aims to close the fistula and restore normal function.
• Vesicovaginal Fistulectomy: This type of fistulectomy targets fistulas between the bladder and the vagina. These fistulas can result from childbirth, surgery, or radiation therapy, and the procedure helps in restoring the separation between these organs.
• Arteriovenous Fistulectomy: This procedure involves the removal of abnormal connections between an artery and a vein, which can cause complications like heart failure or significant blood flow changes. Arteriovenous fistulas may be congenital or acquired due to injury or certain medical conditions.
• Laser Fistulectomy: A minimally invasive approach, laser fistulectomy uses laser energy to precisely remove the fistula tract. This technique is often favored for its reduced recovery time, minimal scarring, and lower risk of infection compared to traditional surgical methods. It's particularly effective for treating anal fistulas and other types where precision is critical.

Why is Fistulectomy Performed?

Fistulectomy is performed to:

• Remove the fistula and prevent recurrence.
• Alleviate symptoms such as pain, discharge, and infection.
• Restore normal function to the affected organs or tissues.
• Prevent complications like abscess formation, sepsis, and chronic inflammation

Who is a Candidate for Fistulectomy?

Candidates for fistulectomy typically include patients with:

• Persistent or recurrent fistulas that do not respond to conservative treatments.
• Fistulas causing significant symptoms or complications.
• Underlying conditions like Crohn’s disease or infections that have resulted in fistula formation.

Preparation of Fistulectomy

Preparation for fistulectomy involves:

• Comprehensive medical evaluation and imaging studies (MRI, CT scan, or fistulogram) to assess the fistula’s location and extent.
• Blood tests to check overall health and organ function.
• Stopping certain medications, such as blood thinners, before the procedure.
• Bowel preparation for intestinal fistulas, which may include fasting and the use of laxatives or enemas.

How is the Fistulectomy Performed?

The steps of the procedure are as follows:

1. Anesthesia: The patient is placed under general or regional anesthesia.
2. Incision: The surgeon makes an incision over the fistula tract.
3. Fistula Removal: The entire fistula tract is carefully dissected and removed.
4. Closure: The affected area is cleaned, and the incision is closed with sutures or staples.
5. Drainage: In some cases, a drain may be placed to prevent fluid buildup and promote healing.

Risks of Fistulectomy

While generally safe, fistulectomy carries some risks, including:

• Infection
• Bleeding
• Recurrence of the fistula
• Damage to surrounding tissues or organs
• Delayed wound healing

Recovery of Fistulectomy

• Hospital stay may be required, depending on the complexity of the surgery and the patient’s condition.
• Pain and discomfort can be managed with medications.
• Follow-up visits are essential to monitor healing and address any complications.
• Patients are advised to avoid strenuous activities and follow specific post-operative care instructions.

Fistulectomy is a vital surgical procedure for removing fistulas and restoring normal function to the affected areas. By addressing the root cause of the symptoms, fistulectomy helps improve patients’ quality of life and prevent further complications.

FAQs

What is the difference between fistulectomy and fistulotomy? 

Fistulectomy involves the complete removal of the fistula tract, while fistulotomy involves opening and draining the fistula without removing the entire tract.

Is fistulectomy a major surgery? 

Fistulectomy can be considered major surgery, especially if it involves complex or deep fistulas. However, the complexity varies depending on the fistula’s location and size.

What are the alternatives to fistulectomy?

Alternatives include fistulotomy, seton placement (a surgical thread to keep the fistula open for drainage), and advanced techniques like fibrin glue or plug insertion. The choice of treatment depends on the fistula’s characteristics and the patient’s overall health.

Can fistulas recur after fistulectomy?

Yes, there is a possibility of recurrence, especially if the underlying cause of the fistula is not addressed. Regular follow-up and management of any underlying conditions are crucial to prevent recurrence.

How long does recovery take after fistulectomy? 

Recovery time varies depending on the fistula’s location and the patient’s overall health. It typically takes a few weeks to several months for full recovery.

Review 

Reviewed By Dr Atul NC Peters - Senior Director - Bariatric, Minimal Access & General Surgery on 05 Sep 2024.