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FILAC

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Introduction

Fistula Laser Closure or FiLaC is a new sphincter conservation technique; it uses a radial laser probe to “burn” the fistula to destroy its wall and granulation tissue and then compress and close it.

Description

By definition, a fistula is a tunnel that connects an organ or body cavity to the surface of the skin or other organ. One might get confused with something called anal fissures. It is a cut or a sharp incision on the skin or mucous membrane in the perianal region, unlike the fistula, connecting the inner and outer body surfaces. If you have either of these problems, you should visit a surgeon.

Anal fistulas are mostly chronic that is form around the anus. It causes repeated infections with or without pus collection. As a result, you might notice secretions, stains, or stool leakage on your underwear, itching at the anal region, and sometimes unhealable acne in the perianal or area surrounding your anus. This is a serious situation that may lead to severe complications. Therefore, it’s necessary to eliminate the problem immediately.

FiLaC is a successful short- to medium-term sphincter conservation technique for treating anal fistulas. However, its long-term success is unknown. This is used for various fistulas in the gut, mainly for anal fistulas.

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What are the Causes of FILAC?

In most cases, people first develop a perianal abscess or pus collected eruption that is caused by the infection of the mucous glands in the inner wall of the anal canal that later develops into an anal fistula. Next, a sudden mild to moderate swelling may occur that is painful with tenderness.

There are various causes for the formation of a fistula, some as follows:

  • ● Sexually transmitted diseases
  • ● Cancer
  • ● Crohn’s disease (inflammation of the gastrointestinal tract)
  • ● Trauma
  • ● Radiation for cancer treatment
  • ● Diverticulitis (inflammation of the large intestine with small spotted pustule formation)
  • ● Tuberculosis

What are the Symptoms of FILAC?

You might see the following symptoms if you have a Fistula:

  • ● Bleeding
  • ● Frequent anal pus formation or abscesses formation
  • ● Fatigue, fever with chills
  • ● Pain and swelling around the anus
  • ● Pain during passing stool
  • ● Irritation of the mucous membrane while passing stool
  • ● Blood in stool
  • ● Malodour of stool
  • ● Pus around the anus

How is FILAC Diagnosed?

Your doctor will look for a hole in the skin or the path of the fistula during your anal examination. The depth and direction of the fistula will be noted during a detailed examination. Sometimes, the fistula is not visible from the outside and might need investigative examinations.

  • ● Anoscopy is a procedure that uses special equipment to examine the inside of the anus and rectum.
  • ● Your doctor may also request an ultrasound or MRI scan of the anal area to observe the fistula better.
  • ● An anesthesia test may sometimes be needed to be examined by the surgeon in the operating room.
  • ● Other tests such as X-rays, blood tests, and even a colonoscopy might be recommended by your doctor.

How is FILAC Treated?

Anal laser fistula treatment has other names such as FiLaC and laser ablation of the fistula tract (LAFT). This has received increasing attention in the past decade with the delivery of 360° laser surgery. Laser ablation is a sphincter-saving technique.

What Are the Results Associated with FILAC Treatment?

After the surgery is completed, you will be taken to the observation room to recover. Regular monitoring of the vitals to avoid any post-surgical complications is done. Once you can stand, you can go home, even if on the same day. Your doctor will give you instructions for wound care and other home preventive measures.

The laxative recommended by the doctor can help soften the stool and relieve discomfort. A sitz bath can also be used to reduce irritation and discomfort in the anal area. It is recommended that you sit in a shallow warm bath several times a day for 10–20 minutes each time. This relaxes the sphincter and promotes healing. You can resume your normal life 4–5 weeks after the operation.

What Are the Risk Associated with FILAC Treatment?

Laser treatment of fistulas preserves the sphincter; therefore, the chance of incontinence after surgery is much lower than that of a fistula incision. It is more conservative and heals faster with lesser chances of postoperative infections.

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FAQ's

What are the Other Treatments of Anal Fistula?

The following are some other treatments:

  • ● Fistula incision
  • ● A flap advancement surgery is done to seal the fistula with a flap or tissue piece, just like removing a trap from the rectum.
  • ● LIFT surgery is done where the skin is opened with the retraction of the sphincter muscles and suturing of the fistula.

Is it an Alarming Condition?

An anal fistula is a disease that requires the respect and timely and accurate treatment of professional surgeons. They often deal with these diseases, and it is best to do it in a professional rectal center.

What is Fistulotomy?

In this process, the skin and muscles above the tunnel open from the tunnel into an open groove, allowing the fistula to heal from the bottom.

Is Laser Fistula Treatment Safe?

Fistula tracts smaller than 30 mm were associated with a primary healing rate of 58.3%, while fistula tracts larger than 30 mm healed only in 16.6% of cases. So, laser closure is safe. It is an effective treatment for transsphincteric anal fistula.

Does Laser Fistula Surgery Hurt?

Laser ​treatment does not cause any pain or bleeding. It is done at the doctor’s office and does not need admission to the hospital. Hence, don’t worry as you can head home the same day after the procedure.

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