What is Laser Fistulotomy?

Laser fistulotomy, also called FiLaC (Fistula Tract Laser Closure), is an advanced procedure that uses a radial laser fiber to deliver controlled energy inside the fistula tract. This seals the tract from the inside while preserving sphincter muscle function. Unlike conventional fistula surgery, laser techniques minimize cutting and reduce the risk of incontinence, making it a safer option for complex or high fistulas.

When is it Needed?

• Chronic anal fistula with persistent discharge or pain
• Recurrent fistula after previous treatments
• Complex or high fistula where sphincter preservation is important
• Failure of medical management or seton placement
• Patients seeking minimally invasive treatment with faster healing

How the Surgery Works

The procedure is performed under spinal or general anesthesia. After identifying and cleaning the fistula tract, a radial-emitting laser fiber is inserted into the tract. The laser energy is applied while slowly withdrawing the fiber, collapsing and sealing the fistula tract from within. This ensures closure without extensive cutting. The procedure typically takes 20–30 minutes and is often performed as a day-care surgery.

Benefits of Laser Fistulotomy

• Minimally invasive with no large incisions
• Preserves anal sphincter function, reducing incontinence risk
• Less pain and minimal blood loss
• Day-care procedure with early discharge
• Faster recovery and quicker return to routine
• Reduced recurrence compared to conventional fistulotomy

Recovery and Aftercare

Most patients recover within 5–7 days and resume normal activities early. Mild discomfort, swelling, or minimal discharge may occur for a short period. Patients are advised to take sitz baths, follow a high-fiber diet, maintain hydration, and practice good perianal hygiene. Regular follow-ups ensure complete healing and help detect any recurrence early.

Why Choose Laser Fistulotomy?

Laser fistulotomy combines precision and safety, making it an excellent choice for fistula management. By avoiding extensive tissue damage and preserving sphincter function, it ensures faster recovery, fewer complications, and better long-term outcomes compared to traditional techniques.