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Abstract

Background: Although anal fistulae are common and well-studied, complex forms remain challenging to treat, requiring a careful balance between preventing recurrence and preserving continence—making minimally invasive techniques like video-assisted anal fistula treatment (VAAFT) a promising option due to their sphincter-sparing approach and ability to accurately identify internal openings and secondary tracts.
Aim: The primary goal of this prospective pilot study is to evaluate the safety and benefits of using the new device “Fistuloscope” for the treatment of anal fistula, as Video Assisted Anal Fistula Treatment (VAAFT) is a novel technique that will be used during this study to treat anal fistula.
Subjects and methods: This prospective pilot study included 20 patients with fistula in ano who were presented to the Department of General Surgery, Faculty of Medicine, Beni-Suef University Hospital, with the study conducted from March 2018 until August 2020 (two years and five months).
Result: The mean age of males was 42.4 years and the mean age of females was 38.2 years. The internal fistula opening was closed by advancement flap in 6 patients (30%) using vicryl 2/0, by stapler in 6 patients (30%) and by primary interrupted sutures using vicryl 2/0 in 8 patients (40%).
Conclusion: VAAFT is a safe and minimally invasive procedure for the treatment of complex anal fistula while preserving anal sphincter function. Neither this study nor other studies mentioned that it was damage to the anal sphincter or fecal incontinence, accordingly- we can consider VAAFT procedure as: Sphincter-Saving Fistula Surgery.