What is Fistula

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An anal fistula commonly known as fistula in ano is a narrow tunnel with its internal opening in the anal canal and its external opening in the skin near the anus. They're usually the result of an infection near the anus causing a collection of pus (abscess) in the nearby tissue. When the pus drains away, it can leave a channel behind. The biggest challenge is to prevent recurrence of fistula.

The risk factors for recurrence can be broadly classified into four categories: 1) The fundamental anatomy of the fistula and presence of comorbid diseases like Tuberculosis, Diabetes, Chronic Disease, Malignancy 2) lack of proper preoperative assessment of the fistula, which includes failure to recognize the internal opening and overall structure of the fistula, 3) intraoperative loopholes that include improper procedure selection, inexperience of the surgeon, and failure to get rid of the entire tract along with its ramifications, and 4) lack of proper postoperative care in the early and late periods following the surgery. Fistulas are classified by their relationship to parts of the anal sphincter complex ( that allow us to control our stool). They are classified as intersphincteric, transsphincteric, suprasphincteric and extrasphincteric.  The intersphincteric is the most common and the extrasphincteric is the least common. These classifications are important in helping the surgeon make treatment decisions.

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Cause Fistula

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More than 90% anal fistulae are a result of an anorectal abscess. An anorectal abscess begins with infection in one of the anal glands. The infection may stay in the space between the sphincters (the intersphincteric space), may spread down to the perianal skin, or may extend through the external anal sphincter.

With a previous history of perianal abscess or any surgical intervention in past, patients having fistula in ano presents with complaints of persistent discharge of pus through an external opening in perianal skin. The other characteristic part of patients complaints include sudden appearance of pain and swelling in the previously dormant perianal region, followed by discharge of pus and relief of pain. Associated fever can also be a feature.

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Symptoms Fistula

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Risk Fistula

The Most Advanced State Of Art Daycare Surgery Centre In Delhi/NCR.

  • Infection


    Fistulas can cause a lot of discomfort, and if left untreated, may cause serious bacterial infection, which may result in sepsis, a dangerous condition that can lead to low blood pressure, organ damage or even death.

  • Incontinence


    In rare cases, surgery can damage the anal sphincter muscles (the ring of muscles that open and close the anus). If the muscles are damaged, you may lose some control of your stool, leading to faeces leaking from your rectum (the area where they are stored). This is known as faecal or bowel incontinence.

  • Recurrence of the anal fistula


    In some cases, the fistula can recur despite surgery. After having a fistulotomy, the recurrence rate can vary depending on factors such as whether it is simple or complex.

Advantage of Fistula Treatment

Advantage of Fistula Treatment over the Traditional Surgical Procedure.

Specifics Fistula Surgery Open Surgery
Cuts And Wounds   No   Yes
Pain   Painless   Painful
Recurrence   No   Yes
Diet Restrictions   No   Yes
Rest After Surgery   Can Resume Work   1-2 Month Rest
Invasive   Minimum   Large

Treatment Fistula

The Most Advanced State Of Art Daycare Surgery Centre In Delhi/NCR.

Diagnosis

A comprehensive rectal examination will be performed by an expert proctologist in our fistula laser hospital. Our doctors usually diagnose an anal fistula by examining the area around the anus. He or she will look for an opening (the fistula tract) on the skin, then try to determine how deep the tract is, and the direction in which it is going.

Tests for identifying fistulas
1.    Contrast tests. A vaginogram or a barium enema can help identify a fistula located in the upper rectum.
2.    Blue dye test.
3.    Computerized tomography (CT) scan.
4.    Magnetic resonance imaging (MRI).
5.    Anorectal ultrasound.
6.    Anorectal manometry.
7.    MRI fistulogram .

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Medicine

The expert proctologist will decide what type of medication a patient needs depending on the diagnosis. Antibiotics may be necessary for the treatment of anal fistulas, especially if the patient presents with systemic symptoms. Once you have an anal fistula, antibiotics alone will not cure it.

You will need to have surgery to cure the fistula.

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Surgery

Surgery is usually necessary to treat an anal fistula as they usually do not heal by themselves.

There are several different procedures. In fact, the surgical procedure chosen by a proctologist will depend on the position of fistula and whether it's a single channel or branches off in different directions. Fistula treatment has been revolutionised over the years by arrival of new age ambulatory surgery or Day Care surgery is a clinical admission for a surgical procedure, with discharge of the patient on the same working day. We have a trained anesthesiologist, OT assistant, and nursing assistant to perform to do the advanced procedures like LASER and LIFT. Dr. Sandip Banerjee is one of the leading Colorectal surgeon practises in all above methods of treatment. But the decision of the modality depends on type of fistula.

Doctor feel anything abnormal sigmoidoscopy test, in this test doctor inserts small fiber-optic camera into your rectum. E

The common minimal invasive surgical procedures are:
Fistulotomy
The most common type of surgery for anal fistulas is a fistulotomy. This involves cutting along the whole length of the fistula to open it up so it heals as a flat scar. A fistulotomy is the most effective treatment for many anal fistulas, although it's usually only suitable for fistulas that do not pass through much of the sphincter muscles, as the risk of incontinence is lowest in these cases.

LIFT procedure
The ligation of the intersphincteric fistula tract (LIFT) procedure is a treatment for fistulas that pass through the anal sphincter muscles, where a fistulotomy would be too risky.
During the treatment, a cut is made in the skin above the fistula and the sphincter muscles are moved apart. The fistula is then sealed at both ends and cut open so it lies flat. This procedure has had some promising results so far

Laser surgery
Radially emitting laser fibre treatment involves using a small laser beam to seal the fistula. Laser closure is a safe and effective treatment for transphinteric anal fistula. FiLaC Fistula-tract Laser Closure, which means the closure of the anal fistula due to the use of a laser procedure involves completely removing the entire length of the fistula tract and closing the internal opening of the fistula using a laser diode source and a radial laser probe. The laser FiLaC procedure for anal fistula therapy is an advanced, safe, effective, minimally invasive, sphincter-preserving procedure with a high success rate.

Our patients and our surgeon will decide on the best anesthesia to use during the surgery. Choices include:
•    general anesthesia, which puts patients into a deep sleep throughout the surgery
•    Saddle block is a low dose of spinal anesthesia which involves medication that numbs your body from the waist down being delivered by a shot into your back
•    local anesthesia, which numbs only your anus and rectum
 

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Aftercare

Patient can expect rectal and anal pain after having surgery. So doctor will prescribe a painkiller to ease the discomfort. Most patients will need a dressing over the surgical incision following the surgical procedure while the wound heals. The dressing needs to be changed regularly, so it is important that they understand how they can do this themselves at home.The following tips may help keep the area around the fistula clean and prevent infection or irritation: 

1) Put a gauze pad over the opening of the fistula to absorb the drainage. This is normal in the days after surgery if needed. 

2) Use warm water and cotton wool to wash the skin, rather than a towel or sponge – pat the skin dry rather than rubbing it, or use a hairdryer on a low setting.

3) Sitz baths may help relieve discomfort and promote healing. A sitz bath is soaking the anal area in plain warm — not hot — water for 15-20 minutes several times a day. ... This helps the area to heal and rarely interferes with the control of bowel movements. Complete healing takes place in a few weeks.

4) Avoid any activities that involve heavy lifting or pulling and long sitting

5) Fiber and laxatives are useful to assist in regular emptying of the bowel and prevent constipation, which can put stress on the operated area.

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Before & After

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World's most advaned Fistula surgery for Fistula

Pelvic Care specializes in providing the best treatment for Fistula. With our own team of doctors, we deliver personalized care according to your medical needs. Our easy admission to discharge process and State of art infrastructure ensures a hassle free experience.

Why Pelvinic Care for Fistula?

Our team of experts is dedicated to offering excellent care to enhance your quality of life through a holistic healing approach and physical therapy. As a specialised one-stop daycare surgical solution, we take pride in dealing with various types of Proctological ailments with utmost attention and care.

Patient Care

Pelvinic is a specialized, team-based approach to support and care for individuals. We strive to provide a home-like environment and the best treatments for our patients for quick recovery. We offer customized services and personal attention to our patients who come for medical treatment and care. Our patient coordinator will receive reports on your condition and all the necessary information to continue your care following your discharge. Our belief is empowering and motivating you to lead a healthy life. Make the right decision today to become a healthier you tomorrow!

Experience

Our team of doctors, surgeons, and other healthcare professionals have been educated, trained and are widely experienced in their particular specialty.With India’s growing population, our doctors have a wider exposure to treating ailments and diseases and therefore are more skilled in providing the right treatments. Our doctors have a vast experience of over 50000 surgeries and are trained in the use of latest diode Laser technology.

Advance Technology

PELVINIC  incorporates the latest technology and medical equipment in patient care that helps the doctors diagnose diseases and treat patients effectively and efficiently.We focus on developing treatment plans as per each patient’s strengths, weaknesses, variety of motions and potential functioning. Our team is equipped with the latest painless techniques that lead to 100% customer satisfaction.

Facilities

Pelvinic hospital offers the complete range of medical and surgical specialties to treat anal diseases under one roof, with highly experienced doctors, paramedical staff and state-of-the-art infrastructure.Our surgical daycare centre is ranked among the best of the best in Delhi (NCR). As we are the first-ever surgical daycare centre for pelvic disorders, we provide early mobilization, a home-like environment for quick recovery and preoperative investigations for our patients.

What We Do?

From giving OPD appointment to diagnose and prescribe surgery, Preoperative test to day-surgery to recovery stay and postoperative and diet instructions, we ensure to give our best of all to our patients without compromising at any stage of the treatment that too at a very cost-effective rate.

  • We have a dedicated staff to ensure your daycare stay is comfortable and hassle-free. our staff will provide you with all the necessary assistance required such as appointment, priority admission, billing and discharge assistance like detailed summary of the hospitalisation including health problems, examination findings, treatment given and procedures performed.
  • The contact details of the treating doctor and staff will be shared so that you and your medical practitioner can keep in touch with him/her post procedure.

Our Doctor

Dr. Sandip Banerjee

Consultant Laparoscopic Coloproctologist

DNB, MNAMS, FACRSI, FMAS, FIAGES, FAIS

With almost 15 years of experience and 5000+ surgeries, Dr. Sandip Banerjee is one of the finest award winning Laparoscopic Colorectal surgeons in Delhi/Ncr for ailments like piles, fistula, anal fissure and anal abscess, pilonidal sinus, anal & rectum cancer. He has particular specialist experience in complex abdominal wall hernias and a general surgical practice including laparoscopic hernia and gallstone surgery, anti-reflux surgery. He is considered to be the best surgeon in South Delhi because of the patients whom he has given a chance to a comfortable life without any pain or worry. He qualified from prestigious BJ Medical College, Pune. He obtained his post-graduation in General Surgery from National Board of examinations (DNB General Surgery). His main clinical interest is Colon and Bowel related diseases and the modern management of haemorrhoids and fistula. He got trained in Laparoscopic Colorectal Surgery from world class doctors Dr. Joel Leroy (France) and Dr. A Melany (Brazil) and AIIMS Delhi. With an interest in Gastro Intestinal cancer surgery, Dr Sandip completed two years fellowship in GI oncology under the leadership of Dr Adarsh Chaudhary from premier MEDANTA hospital Gurgaon. He also completed fellowship in Bariatric Surgery after this. He is currently working as a Head Laparoscopic and Colorectal Surgeon in Apollo Spectra, Kailash Colony New Delhi, and also associated with Rainbow Hospital, Fortis Hospital, National Heart Institute, Indraprastha Apollo Hospital Sarita Vihar and several other prime South Delhi Hospitals as a senior visiting consultant. His previous assignments were with MAX Smart Saket, Fortis Gurgaon, and Medanta Gurgaon. He has been awarded as INDIA’S BEST DOCTORS AWARD for the best laparoscopic surgeon in Delhi and Achievers Award by All India Achievers Association    

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Patient Testimonial

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Ms. Alina

Ghazibad

A young patient was suffering form 4th grade haemorrhoids as she was neglecting her problem for quite long. She came to our clinic in severe pain and after undergoing preliminary tests, she underwent Stapler surgery for hemorrhoids. She is presently fit and fine and do advises for early detection and treatment to all patients with Piles problem.

Mrs. Rubina Parveen

Lucknow

30 years old was having Gall Bladder Stone with gastroesophagial reflux and severe acidity problems. Dr. Sandip operated her for Laparoscopic gall bladder removal surgery and medical management of GERD.

Mr. Anand Prakash

New Delhi

38 years old, Charted Accountant and a foodie was diagnosed to have Wide Hiatus Hernia defect ( more than 3 cm) and severe acid reflux problems. He was scared of eating out in restaurants and parties due to his gastritis and reflux. After taking antireflux medications for 3 months, Dr Banerjee operated on him Laparoscopic antireflux surgery ( Toupet’s fundoplication) and 2 weeks following he has again started relishing foods of different taste.

Dr. S. K. Jain

Noida

Himself is a Pediatrician, was having suffering form Inguinal Hernia and chronic deep perianal ( high intersphincteric, uncommon)abscess . His problems were identified, diagnosed and operated by Dr. Banerjee ( Laparoscopic TEP hernioplasty and abscess drainage). He has high regards for PELVINIC

Frequently Ask Question

The Most Advanced State Of Art Daycare Surgery Centre In Delhi/NCR.

How do you control enterocutaneous fistula?

The initial stage of EC fistula management consists of its identification, followed by general supportive care with fluid and electrolyte replacement, control of sepsis, nutritional support and control of fistula drainage by pharmacologic means as well as through skin protection

How is an Oroantral fistula treated?

Treatment modalities to repair the oroantral fistula include local or free soft tissue flaps, with or without autogenous grafts or alloplastic implants. The closure of an oroantral communication of any origin, can be achieved by different techniques

Why is fistula called the silent epidemic?

Obstetric Fistula is a silent epidemic in Africa. It’s a hole in the birth canal caused by prolonged, obstructed labour due to lack of timely and adequate medical care

How long does sinus perforation take to heal?

A small perforation will usually heal by itself, provided that a decent clot forms in the socket. It is important that the clot does not dislodge, and the patient should therefore be advised to refrain from blowing his/her nose vigorously for 3–4 weeks.
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