Surgical Options For Anal Fistula Treatment

Anal fistulas can be an uncomfortable ailment with sometimes painful symptoms persisting. The good news is your colorectal specialist can use a number of surgeries to treat anal fistulas. In this article we will explore the different ways you can treat an anal fistula using surgery.

What is an anal fistula?

An anal fistula is a small tunnel that develops between the end of the bowel and the skin near the anus. Anal fistula is the result of an anal abscess, occurring in up to 50% of patients with abscesses. Occasionally, these glands get clogged and can become infected, leading to an abscess. When the pus drains away, it can often leave a small channel behind.

Anal Fistula Treatment

It’s likely that your colorectal specialist’s preferred treatment for anal fistula will be surgery. There are several different procedures for anal fistula surgery. The best option for you will depend on the position of your fistula and whether it's a just one channel or multiple. Here are a few of the most common anal fistula surgery options:


You may be wondering “what is a fistulotomy?” if your colorectal specialist has mentioned it as a course of action for your anal fistula. A fistulotomy is the most common type of surgery for anal fistulas, and involves cutting along the whole length of the fistula to open it up and drain it. A fistulotomy is the most effective treatment for many anal fistulas, though it may be too risky in some cases.

Seton technique

If your fistula passes through a significant portion of anal sphincter muscle, your colorectal specialist may recommend inserting a seton. A seton is a portion of thread that's left in the fistula for several weeks to keep it open, which allows it to drain and heal and avoids needing to cut the sphincter.

Advancement flap procedure

An advancement flap procedure may be considered if your fistula passes through the anal sphincter muscles and performing a fistulotomy isn’t an option for surgical treatment. This procedure cuts the fistula, then covers the hole with a flap of tissue taken from inside the rectum. Though the procedure has a lower success rate than the traditional fistulotomy, it’s still performed under certain circumstances.

Other surgical options include:

  • The LIFT procedure – a newer procedure for anal fistula that passes through the sphincter during which an incision is made in the skin above the fistula and the sphincter muscles are moved apart.

  • Endoscopic ablation - an endoscope (or a flexible tube with a camera on the end) is put in the fistula, then an electrode passes through the endoscope and is used to seal the fistula.

If you need surgery to correct an anal fistula, call to make a consultation with the colorectal specialists at Tampa Bay Colorectal today and leave your care in good hands!