The aim of all surgical approaches to correct a fistula is to make the fistula itself – the tunnel that forms and connects internal tissue with the opening on the skin - close. The most appropriate surgical approach – or combination of approaches – (there are five approaches, listed below) will be determined based on where the fistula is and how big it is.
A prime consideration in the choice of approach is to avoid affecting or damaging the sphincter muscle, as this can lead to faecal incontinence. The five common approaches to fistula correction surgery are:
- Anal fistulotomy.
- Fistula plug.
- Ligation of intersphincteric fistula tract.
- Mucosal advancement flap.
- Seton drain.
Before surgery, Dr White will discuss the surgical options in detail with you.
How should I prepare for surgery?
The day before admission we will contact you to confirm admission time and to give you instructions regarding any fasting requirements for the procedure. You should bring any x-rays in with you (and ensure you take them with you when you are discharged). Also bring any current medication in with you to the hospital.
For day procedures you should not drive yourself home when you are discharged – please ensure you have made other transport arrangements.
If you smoke, you should reduce smoking before your procedure. Our strong recommendation is that you give up entirely at least 6 weeks before the procedure, or at least one week beforehand. Smoking greatly increases the possibility of chest infection and hampers natural wound healing.
In the case of major surgery, please inform Dr White's team if you take:
- Anti-inflammatory medication.
We will need to discuss these medications with you prior to your surgery.
Dr White will provide you with a full set of pre-operative instructions for your specific surgery well ahead of the day of surgery.
See the recovery guidelines section on the Fissure Surgery page.
All types of surgery are subject to the following risks, which are rare, but can occur:
- Allergic reaction to medication / anaesthetic.
- Difficulty breathing.
Although rare, complications relating to anal fistula surgery may also include:
- Faecal incontinence (more common in females and in sufferers of Crohn's Disease; overall 3-7% risk).
- Recurrence of fistula (overall 7-21% risk).
When to contact Dr White
Most surgical procedures are uneventful, with minimal complications. However, you need to be aware of the following symptoms as they may indicate a developing serious complication...
- Excess bleeding.
- Difficulty urinating.
- Severe or increasing pain.
If you experience any of these symptoms or have any concerns after your surgery, please contact the rooms on 07 5598 0955 for advice.
A post operative appointment will be made for you before you are discharged from hospital. If you are discharged on a weekend, after normal surgery hours or it is not clear what follow up appointments are required, then contact the rooms the next working day to make an appointment.