Anal Fistula Surgery at Mandaya Royal Hospital Puri with Expert Surgeons

An anal fistula is an abnormal small tunnel that forms between the inside of the anus and the surrounding skin, often developing as a result of an infection or abscess that does not heal properly. This condition may cause symptoms such as pain around the anus, discharge of pus or foul-smelling fluid, skin irritation, and discomfort when sitting or during bowel movements. If left untreated, an anal fistula can lead to recurrent infections, chronic pain, and a significant decline in the patient’s quality of life.

At Mandaya Royal Hospital Puri, anal fistula surgery is handled by an experienced team of anal fistula specialists, consisting of highly skilled general surgeons and digestive surgeons. With deep clinical expertise and the use of modern surgical techniques, the team ensures that every patient receives safe, effective, and tailored treatment. This multidisciplinary approach helps minimize the risk of complications and increases the likelihood of optimal healing.

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Anal Fistula Surgery at Mandaya Royal Hospital Puri

The treatment approach for anal fistula depends on the location of the fistula tract, its complexity, and the underlying cause. The main goal of therapy is to completely close the fistula to prevent recurrence, while also maintaining the normal function of the sphincter muscle. Damage to this muscle can result in fecal incontinence. Although surgery is generally the primary treatment, non-surgical options may be considered in selected cases.

Common surgical techniques include:

1. Fistulotomy

In this procedure, the surgeon opens the internal fistula tract, cleans the infected tissue, flattens the tunnel, and sutures the area to allow proper healing. In more complex cases, parts of the tract may need to be removed. A two-stage fistulotomy may be performed if the entire tract cannot be identified at once or when a significant portion of the sphincter muscle is involved.

2. Endorectal advancement flap

This technique involves creating a flap from the rectal wall and using it to close the internal opening of the fistula after the affected tissue is removed. This method preserves more of the sphincter muscle, reducing the risk of impaired muscle function.

3. Ligation of the intersphincteric fistula tract (LIFT)

The LIFT procedure is a multi-step technique designed to treat deep or complex fistulas. This approach gives the surgeon access to the fistula between the sphincter muscles without cutting them. During the first stage, a silk or latex seton is placed to gradually widen the tract. Several weeks later, the infected tissue is removed and the internal opening is closed.

For very complex anal fistulas, more advanced procedures may be required, such as:

Ostomy and stoma

A temporary opening is created in the abdominal wall to divert stool away from the anus. Waste is collected in a special pouch, allowing the affected area to heal without irritation.

Muscle flap

In severe cases, the fistula tract may be closed using healthy muscle tissue taken from the thigh, buttocks, or labia to support healing and reconstruct the damaged area.

Anal Fistula Specialist Surgeons at Mandaya Royal Hospital Puri

Below is the list of competent general and digestive surgeons at Mandaya Royal Hospital Puri who manage anal fistula cases:

1. dr. Erwin Suryanegara, Sp.B, MSI.Med

dr. Erwin Suryanegara, Sp.B, MSI.Med is a general surgeon who has managed numerous anorectal cases, including anal fistulas. He completed his surgical training at Diponegoro University and earned a Master’s degree in Biomedical Sciences. In addition, he has completed various trainings such as Basic–Advanced Laparoscopic programs and anorectal surgical techniques, strengthening his expertise in providing safe and comprehensive care.