Fistulotomy
What is Fistulotomy? Fistulotomy is the standard operation for low, simple anal fistulas, which make up the majority of cases. Typical duration at Iswarya Hospital, OMR Chennai: 15–30 mins. Recovery: 2–4 weeks.
The surgeon passes a probe through the tract and divides the small amount of tissue over it, laying the tunnel open into a shallow groove that heals from the base over a few weeks. Because only a small portion of the lower sphincter is involved, continence is preserved, and the cure rate exceeds 90%. For fistulas that cross more muscle, sphincter-saving options such as laser ablation or a seton are used instead.
Medically reviewed by Dr. Durai Ravi, Senior Consultant – General, Advanced Laparoscopic, Laser & Robotic Surgeon · Updated 9 October 2026
How is Fistulotomy performed?
- 1
Spinal or general anaesthesia is given.
- 2
The external opening is identified and a probe is passed along the tract to the internal opening.
- 3
Hydrogen peroxide or dye may be used to confirm the tract.
- 4
The tissue over the probe is divided, laying the tract open along its length.
- 5
The base of the tract is scraped clean and edges trimmed so it heals flat.
- 6
The wound is left open and a dressing applied.
What are the benefits of Fistulotomy?
- ✓Cure rate above 90% for low fistulas
- ✓Quick day-care operation
- ✓Low recurrence and no implant or foreign material
- ✓Small wound that heals steadily
- ✓Return to work within 1–2 weeks
How do you prepare for Fistulotomy?
- Examination, and an MRI if the fistula is complex, to confirm the tract is low and simple.
- Fast for 6 hours before the procedure.
- An enema is given in the morning.
- Stop blood thinners as instructed.
- Arrange to be collected the same day.
What are the risks and side effects of Fistulotomy?
- Minor leakage of gas or mucus in a small percentage of patients
- Bleeding or infection of the open wound
- Recurrence if a branch of the tract is missed
- Delayed healing in smokers or diabetics
- Unsuitable for high fistulas because too much muscle would be cut
Your surgeon will discuss all risks with you before the procedure and take appropriate precautions to minimise them.
What is recovery like after Fistulotomy?
- Sitz baths after every bowel motion and at bedtime.
- Keep stools soft with fibre, water and a softener.
- Simple dressing or pad; showering is encouraged.
- Weekly review until healed to make sure the wound heals from the base, not the surface.
- Return to desk work within a week.
Frequently asked questions about Fistulotomy
Will fistulotomy affect my bowel control?
For low fistulas only a small part of the lowest sphincter fibres is involved, and control is preserved. Some patients notice minor difficulty holding wind for a few weeks, which settles.
How do I know if my fistula is low or high?
Your surgeon assesses this by examination and, when needed, MRI. Low fistulas pass through the lower third of the sphincter and are safe to lay open; high fistulas need sphincter-saving treatment.
How long does the wound take to heal?
Typically 3–6 weeks. Regular sitz baths and keeping the wound clean speed healing.
Is fistulotomy done as day care?
Yes. Most patients go home a few hours after the operation.
Where can you get Fistulotomy 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.