Dr. Pawan LalMBBS, MS (Surgery), DNB (Surgery), MNAMS, FIAS, FICS, FIAGES, FIMSA, DA. Professor of Surgery, Maulana Azad Medical College, New Delhi, India. Email:info@pawanlal.com, M: +91 9968604405

Fistula in Ano

Fistula in Ano are classified as High and low fistula in Ano. The conventional method of management is surgical excision of the fistulous tract, but surgical management leads to lot of scarring and also recurrence is common.

The other unconventional methods are use of fibrin glue, fibrin plug, nectacryl ( cynaoacrylate glue) etc., but even with these the recurrence is common as it does not lead to satisfactory management of the primary pathology that is the diseased anal gland which led to the formation of the fistula in Ano.

This had led to resurgence in the interest in use of medicated seton (Kshara sutura) for use in the management of the Fistula in Ano. It leads to less scarring and does not require admission of the patient to the hospital. The treatment is done on OPD basis.


Pics of Insertion of the seton in low fistula in ano on OPD basis


Fistual in Ano - insertion of seton

seton insertion

Seton insertion

seton insertion

seton insertion

Seton Insertion

Seton Pulled through the fistula and tied

The Seton has started cutting through the tract

The seton has almost cut through the Fistula with healing of the tract and only skin tag is left