title: Video-assisted anal fistula treatment.
abstract: OBJECTIVE
  Fistula in ano is a common disease seen in the surgical outpatient department. Many procedures are advocated for the treatment of fistula in ano. However, none of the procedures is considered the gold standard. The latest addition to the list of treatment options is video-assisted anal fistula treatment (VAAFT). It is a minimally invasive, sphincter-saving procedure with low morbidity. The aim of our study was to compare the results with a premier study done previously.
  
  
  METHODS
  The procedure involves diagnostic fistuloscopy and visualization of the internal opening, followed by fulguration of the fistulous tract and closure of the internal opening with a stapling device or suture ligation. The video equipment (Karl Storz, Tuttlingen, Germany) was connected to an illuminating source.
  
  
  RESULTS
  The study was conducted from July 2010 to March 2014. Eighty-two patients with fistula in ano were operated on with VAAFT and were followed up according to the study protocol. The recurrence rate was 15.85%, with recurrences developing in 13 cases. Postoperative pain and discomfort were minimal.
  
  
  CONCLUSIONS
  VAAFT is a minimally invasive procedure performed under direct visualization. It enables visualization of the internal opening and secondary branches or abscess cavities. It is a sphincter-saving procedure and offers many advantages to patients. Our initial results with the procedure are quite encouraging.
authors.affiliation: Department of Surgery, Lady Hardinge Medical College, New Delhi, India.
authors.forename: Gaurav
authors.initials: G
authors.lastname: Kochhar
authors.affiliation: Department of Surgery, Lady Hardinge Medical College, New Delhi, India.
authors.forename: Sudipta
authors.initials: S
authors.lastname: Saha
authors.affiliation: Department of Surgery, Lady Hardinge Medical College, New Delhi, India.
authors.forename: Manoj
authors.initials: M
authors.lastname: Andley
authors.affiliation: Department of Surgery, Lady Hardinge Medical College, New Delhi, India.
authors.forename: Ashok
authors.initials: A
authors.lastname: Kumar
authors.affiliation: Department of Surgery, Lady Hardinge Medical College, New Delhi, India.
authors.forename: Gyan
authors.initials: G
authors.lastname: Saurabh
authors.affiliation: Department of Surgery, Lady Hardinge Medical College, New Delhi, India.
authors.forename: Rahul
authors.initials: R
authors.lastname: Pusuluri
authors.affiliation: Department of Surgery, Lady Hardinge Medical College, New Delhi, India.
authors.forename: Vikas
authors.initials: V
authors.lastname: Bhise
authors.affiliation: Department of Surgery, Lady Hardinge Medical College, New Delhi, India.
authors.forename: Ajay
authors.initials: A
authors.lastname: Kumar
mesh_terms: D000328:Adult; D004564:Electrocoagulation / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D012003:Rectal Fistula / Q000601:surgery*; D017792:Surgical Stapling / Q000379:methods; D016896:Treatment Outcome; D020535:Video-Assisted Surgery / Q000379:methods*
keywords: Fistula in ano; Fistuloscopy; Sphincter-saving surgery; Video-assisted anal fistula treatment (VAAFT); Visual analog score (VAS)