Role of video assisted anal fistula treatment in our management of fistula-in-ano

Background: Video-assisted anal fistula treatment is a new method used for treatment of complex perianal fistula with maximal sparing of sphincter muscles and prevention of false route. Authors inform about their experience and operative results. Aims: Our aim was to verify feasibility of the method, help in internal opening identification and define its position in our management of perianal fistulas. Methods: Patients with chronic fistula-in-ano of IBD and non-IBD benign etiology were enrolled. Anoscopy with fistuloscopy was attempted in all patients followed by loose seton drainage or other procedure. Results: Fistuloscopy was attempted in 30 patients, finished in 93% and internal opening was found in 67%. No procedure-related morbidity was observed. Conclusion: Fistuloscopy alone is feasible for diagnosing type of IBD and non-IBD fistulas. VAAFT technique and instruments were helpful for identification of an internal opening in most cases. As such it has established role in our management of fistula-in-ano.