Radio Frequency Fistulotomy: An Effective Modification Of The Conventional Technique

Abstract

Background: The techniques in vogue for treating fistula are fistulectomy, fistulotomy, curettage of fistula, and placement of flaps of mucosa or skin, placement of medicated Setons, insertion of antibiotic beads, and injection of commercial or autologous fibrin glue. Of all these procedures, majority of the surgeons continue to prefer the classical technique [fistulotomy] as the procedure of choice in 90% of anal fistulae. Materials & Methods: In this retrospective study, the conventional lay open technique, or has been performed by employing the radio frequency surgical device as an alternative to the traditional knife and scissors. In a span of 18 months starting from July 1999 to December 2000, 210 cases of fistula in ano of low variety were operated exclusively applying the radio frequency device. Observations: A follow up of the operated patients with radio frequency surgery over a period of 15 months, i.e. from December 2000 to March 2002 could be summarized as below. A] Average time taken by the patient to resume routine 7 days. B] None of the patient had any interference with anal continence. C] The wounds were found healed within an average time of 47 days. D] Delayed wound healing was noticed only in 7 patients. E] Recurrence/ failure rate was as low as 1.5 percent. Conclusion: This technique has been found superior to the conventional fistulotomy in the sense that the time taken for the whole procedure was reduced to almost half, amount of bleeding was minimum, the post operative pain was less compared to conventional method and return to work was much quicker.