✦ ANAL FISTULA · ENDOSCOPIC

VAAFT Procedure for Anal Fistula

Q: How successful is VAAFT for anal fistulas?

VAAFT achieves cure rates of 65–87% depending on fistula complexity. For complex transsphincteric fistulas, treatment can be repeated without cumulative sphincter damage.

Q: Will I need more than one VAAFT procedure?

Some patients require 2 sessions for complete tract closure. Multiple VAAFT procedures carry no accumulating incontinence risk.

Q: What happens if VAAFT does not cure the fistula?

If VAAFT fails, other sphincter-preserving options — FiLaC laser, LIFT, or advancement flap — remain fully available.

Video-Assisted Anal Fistula Treatment — direct endoscopic tract visualisation and ablation with complete sphincter preservation.

30–60 Min TREATMENT DURATION

Day Care CARE SETTING

Endoscopic APPROACH

3–5 Days RECOVERY TIMELINE

What is VAAFT Procedure for Anal Fistula?

An anal fistula is an abnormal tunnel between the anal canal and perianal skin, usually caused by a previous perianal abscess. VAAFT uses a fistuloscope — a miniature camera passed through the external opening — to directly visualise the entire tract, identify all secondary branches, and ablate the lining from within under magnification. Dr. Tagore Mohan Grandhi performs VAAFT. The key advantage over conventional fistulotomy is complete sphincter preservation — no sphincter muscle is divided at any point, eliminating incontinence risk while treating complex and high fistulas.

Suitable for patients with complex, high transsphincteric, or suprasphincteric fistulas where fistulotomy (laying open) would risk incontinence due to the amount of sphincter muscle involved.

How the Procedure Works

Fistuloscope Insertion

Rigid fistuloscope passed through the external opening into the fistula tract. Continuous irrigation maintains clear magnified vision throughout.

Tract Mapping

Entire fistula tract and all secondary extensions visualised under direct endoscopic magnification. Internal opening identified precisely.

Electrocautery Ablation

Fistula tract epithelium destroyed under direct vision using electrocautery passed through the fistuloscope working channel.

Internal Opening Closure

Internal opening sutured closed with an absorbable suture to prevent recurrent contamination from the gut.

Recovery

Same-day discharge. Review at 6 weeks. MRI if fistula persists. Repeat procedure possible without additional sphincter risk.

Outcomes

30–60 MinTREATMENT DURATION

Day CareCARE SETTING

EndoscopicAPPROACH

3–5 DaysRECOVERY TIMELINE

Who Needs This Treatment?

→Zero risk to sphincter muscles — complete continence preservation throughout
→Direct visualisation of entire tract — identifies secondary branches missed on MRI
→Same-day discharge — day surgery with minimal post-procedure discomfort
→Repeatable without cumulative sphincter damage if further sessions needed

VAAFT lets us see and treat the entire fistula from within, under magnification with perfect tract identification. For complex fistulas, it is the most sphincter-protective technique available.

— Dr. Tagore Mohan Grandhi, Senior Consultant Gastrointestinal Surgeon, Lux Hospitals, Hyderabad

Common Questions

Frequently Asked Questions

How successful is VAAFT for anal fistulas?+

Will I need more than one VAAFT procedure?+

What happens if VAAFT does not cure the fistula?+

Not sure which treatment is right for you?

Book a consultation with Dr. Tagore Grandhi and get a personalised treatment plan.

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