title: VAAFT: Video Assisted Anal Fistula Treatment; Bringing revolution in Fistula treatment.
abstract: OBJECTIVE
  To share our findings that the new treatment modality Video Assisted Anal Fistula Treatment (VAAFT) is a better alternate to the conventional treatments of Fistula in Ano in our setup with minor changes in the initial method described by Meinero.
  
  
  METHODS
  Karl Storz Video equipment including Meinero Fistuloscope was used. Key steps are visualization of the fistula tract, correct localization of the internal fistula opening under direct vision and endoscopic treatment of the fistula. This is followed by an operative phase of fulguration of the fistula tract using glycine solution mixed with manitol, curetting the tract with curette and fistula brush. Internal opening is closed with a Vicryl 1 suture.
  
  
  RESULTS
  Total of 40 patients were operated using VAAFT from October 2013 to March 2014. Three were re-operated. The other 37 cases were followed up at 6 weeks, 3 months and 6 months. Primary healing took place in 20 (50%) cases at 6 weeks. In the remaining 17 (42.5%) cases, minor discharge occurred with itching which resolved till the next visit at 8 weeks and 12 weeks.
  
  
  CONCLUSIONS
  As the main aim in treating fistula is proper identification of the internal opening, excision of the tract and sparing the sphincter function, VAAFT achieves all aims with additional benefits of patients' satisfaction and negligible scaring.
authors.affiliation: Dr. Mohammad Zarin, FCPS Gen Surgery (Pak), FMAS (Ind), MRCS (Eng). Consultant Surgeon and Associate Professor, Surgical E Unit Khyber Teaching Hospital Peshawar. Surgical "E" Unit, Khyber Teaching Hospital, Peshawar, Pakistan.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Zarin
authors.affiliation: Dr. Muhammad Imran Khan, FCPS (Gen Surgery). Consultant Surgeon and Senior Registrar, Surgical E Unit Khyber Teaching Hospital, Surgical "E" Unit, Khyber Teaching Hospital, Peshawar, Pakistan.
authors.forename: Muhammad Imran
authors.initials: MI
authors.lastname: Khan
authors.affiliation: Dr. Mukhtar Ahmad, FCPS (Gen Surgery). Associate Professor Surgical A Unit, Ayub Teaching Hospital, Abbottabad, Pakistan.
authors.forename: Mukhtar
authors.initials: M
authors.lastname: Ahmad
authors.affiliation: Dr. Muhammad Ibrahim, 4 Year General Surgery Resident, Surgical "E" Unit, Khyber Teaching Hospital, Peshawar, Pakistan.
authors.forename: Muhammad
authors.initials: M
authors.lastname: Ibrahim
authors.affiliation: Dr. Muhammad Asim Khan, Ist Year General Surgery Resident, Surgical "E" Unit, Khyber Teaching Hospital, Peshawar, Pakistan.
authors.forename: Muhammad Asim
authors.initials: MA
authors.lastname: Khan
keywords: Anal fistula; Meinero Fistuloscope; VAAFT