Performed by Dr. Ravi Chandra Reddy Obili at Dr Ravi Chandra Reddy
Fistula-in-Ano surgery is a procedure to treat an anal fistula—an abnormal tunnel that forms between the inside of the anal canal and the skin around the anus. This condition often develops after an abscess and can cause persistent drainage, pain, and infection. Surgery aims to close the fistula tract while preserving the anal sphincter muscles that control bowel movements.
We believe in honest, upfront disclosure so you can make an informed decision.
A step-by-step look at what happens during this procedure.
Spinal or general anaesthesia is given so you feel no pain during the procedure.
The surgeon examines the anal area and uses a probe to identify the fistula tract and its course through the tissues.
Depending on the fistula type and location, the tract may be laid open, excised, or treated with techniques that preserve sphincter muscles.
The fistula tract is cleaned and any infected tissue is removed to allow healing from the base upward.
The wound is usually left open to heal naturally, or in some cases a seton (drain) may be placed to keep the tract open temporarily.
A structured, patient-first approach from first consultation to full recovery.
Dr Ravi Chandra Reddy evaluates the fistula through examination and imaging if needed, to understand its path and relation to the sphincter muscles.
The technique is chosen based on the fistula complexity—whether simple fistulotomy, seton placement, or sphincter-sparing methods are most suitable.
During surgery, care is taken to preserve as much sphincter muscle as possible to maintain bowel control while ensuring the fistula is adequately treated.
Detailed instructions on wound care, hygiene, pain management, and activity restrictions are provided to support healing and prevent complications.
What to expect at each stage of your recovery journey.
In the first few days, pain and discomfort are common. Keep the area clean, take prescribed medications, and avoid straining. Individual instructions from your surgical team take priority.
Over the next 2-4 weeks, the wound gradually heals from the inside out. Regular sitz baths and gentle hygiene help. Activity is slowly increased as tolerated, avoiding heavy lifting and strenuous exercise.
Full healing may take 8-12 weeks depending on fistula complexity and individual factors. Follow-up visits monitor progress and address any concerns. Timelines vary; your individual recovery may differ.
The goal of surgery is to close the abnormal tract and allow the wound to heal, relieving drainage and discomfort. Complete healing depends on fistula complexity and individual healing response.
Techniques aim to preserve sphincter muscle function and maintain bowel control. However, complex or recurrent fistulas may carry a higher risk of some impact on continence.
Some fistulas may recur after surgery, particularly complex or Crohn's-related tracts. Recurrence does not mean the procedure failed—it reflects the nature of the condition and may require additional treatment.
Surgery addresses the fistula tract but does not treat underlying conditions like Crohn's disease. Ongoing management of the underlying cause may be needed to reduce the chance of recurrence.
The right choice depends on your diagnosis, risks and circumstances — discussed with you at your consultation.
For small or minimally symptomatic fistulas, especially in people with Crohn's disease, medications and watchful waiting may be considered before surgery. The choice depends on symptoms and individual risk.
A seton (surgical thread) can be placed through the fistula to promote drainage and prevent abscess formation without definitive excision. This may be used as a temporary measure or long-term management in complex cases.
Options such as LIFT procedure, fibrin glue, or fistula plugs may be considered for complex fistulas where preserving sphincter function is critical. Suitability is determined by the fistula's anatomy and previous treatment history.
Let's clear up some of the most common myths about fistula-in-ano surgery.
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