Perianal Fistulas – Endoscopic VAFT Technique
Perianal fistulas are a common septic condition affecting the perianal region and frequently develop following a perianal abscess.
Symptoms include pain, swelling, redness, and discharge of seropurulent fluid. Fever may also occur, particularly when an abscess is present. In some patients, perianal fistulas are associated with inflammatory bowel diseases, such as Crohn’s disease.
Modern Treatment with the VAFT Technique
Treatment is generally surgical. VAFT (Video-Assisted Fistula Treatment) is a minimally invasive technique that uses a dedicated fistuloscope to identify and map the fistula tract, allowing its endoscopically guided treatment using electrocautery.
A major advantage of this technique is the ability to treat the fistula while minimizing tissue trauma and aiming to preserve the function of the anal sphincters, thereby reducing the risk of postoperative fecal incontinence.
Following appropriate assessment, the VAFT technique may also be used for complex or recurrent fistulas. Preoperative MRI of the perianal region helps accurately define the fistula tract and its relationship to the anal sphincters, supporting optimal surgical planning.
The choice of surgical technique is individualized, with the primary goals of effective fistula treatment, preservation of anal sphincter function, and maintenance of continence.
