Royal Prince Alfred Hospital
Royal Prince Alfred Hospital
Department of Colorectal Surgery

Colorectal Surgery

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Fistulotomy

A fistulotomy is a surgical procedure used to treat an anal fistula – an abnormal channel or tunnel-like lesion that starts inside the anus and ends outside on the skin of the buttocks.

The procedure involves dividing the tissue between the skin and the fistula opening, turning the tunnel-like opening of the fistula into a groove to allow the fistula to heal from the inside out.

A fistulotomy can be performed once the surgeon has assessed the site of the fistula for suitability to help prevent complications like anal or faecal incontinence.

Depending on the type of fistula and wound, the surgeon may leave the resulting would open with dissolvable sutures to help wound healing.

You will be given specific instructions on the day of surgery, but they usually include regular warm salt or sitz baths, avoiding hard wiping of the area, the use of perianal pads, and taking of stool softeners, pain medicine, fibre supplements and possibly a laxative. A nerve block in the area provides pain relief on the day, and medications will be given to minimise pain or any ongoing discomfort.

Following surgery there are risks of bleeding and infection, and longer term risks of inability to control flatus of bowel movements, but it is best to discuss these with your doctor for more specific details related to your fistula and your planned surgery.