Fistulectomy
What is Fistulectomy? Fistulectomy removes the entire fistula tract as a core of tissue, from the external opening on the skin to the internal opening in the anal canal. It differs from fistulotomy, which lays the tract open but does not remove it. Typical duration at Iswarya Hospital, OMR Chennai: 30–45 mins. Recovery: 3–6 weeks.
Fistulectomy is chosen for recurrent fistulas, thick fibrous tracts, and when tissue is needed for examination to rule out tuberculosis, Crohn's disease or tumour. The resulting wound is left open to heal from the base, and any sphincter muscle involved is divided only if it is safe to do so.
Medically reviewed by Dr. Durai Ravi, Senior Consultant – General, Advanced Laparoscopic, Laser & Robotic Surgeon · Updated 9 October 2026
How is Fistulectomy performed?
- 1
Spinal or general anaesthesia is given.
- 2
The tract is identified with a probe and dye to confirm its path and internal opening.
- 3
The external opening and the surrounding tract are excised as a core of tissue.
- 4
The dissection follows the tract up to the internal opening, which is excised.
- 5
Muscle involvement is assessed; a seton is placed instead of division if too much sphincter is crossed.
- 6
The wound is left open, packed and dressed.
What are the benefits of Fistulectomy?
- ✓Removes the whole tract, reducing the chance of recurrence
- ✓Provides tissue for histology to identify underlying disease
- ✓Effective for fibrous, recurrent or branching fistulas
- ✓Definitive cure when combined with proper wound care
- ✓Familiar, well-established technique
How do you prepare for Fistulectomy?
- MRI fistulogram or endoanal ultrasound maps the tract and its relation to the sphincter.
- Blood tests and, if indicated, tests for tuberculosis or inflammatory bowel disease.
- Fast for 6–8 hours before surgery.
- An enema is given in the morning.
- Stop blood thinners as instructed and control blood sugar tightly.
What are the risks and side effects of Fistulectomy?
- Larger wound and longer healing than fistulotomy or laser
- Risk to continence if a significant amount of sphincter is removed
- Bleeding and infection of the open wound
- Recurrence if a side branch is missed
- Delayed healing in diabetics and smokers
Your surgeon will discuss all risks with you before the procedure and take appropriate precautions to minimise them.
What is recovery like after Fistulectomy?
- Daily wound cleaning and dressing, taught to the patient or a family member.
- Sitz baths after each bowel motion.
- High-fibre diet and stool softeners to avoid straining.
- Weekly review until the wound has healed from the base.
- Avoid sitting for long periods and cycling for 4 weeks.
Frequently asked questions about Fistulectomy
What is the difference between fistulectomy and fistulotomy?
Fistulotomy opens the tract along its length and leaves it to heal flat. Fistulectomy cuts out the entire tract as a strip of tissue. Fistulectomy leaves a bigger wound but gives tissue for testing and is preferred for recurrent or hardened tracts.
How long does the wound take to heal?
Usually 4–8 weeks depending on the size of the tract. Regular dressing changes and keeping the wound clean are essential.
Can a fistula come back after fistulectomy?
Recurrence is low, around 5–10%, and usually happens when a side branch was hidden. MRI mapping before surgery reduces this risk.
Where can you get Fistulectomy in Chennai?
Iswarya Hospital's General & Laparoscopic Surgery department performs a wide range of procedures using minimally invasive (keyhole) techniques for faster recovery, less pain, and shorter hospital stays — including hernia repair, gallbladder removal, appendectomy, and piles/fistula surgery.
Sources and further reading
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ℹ️ This information is for educational purposes only and does not constitute medical advice. Individual treatment plans may vary. Always consult a qualified healthcare professional before making any medical decisions.