Laser Fistula Ablation
What is Laser Fistula Ablation? Laser fistula ablation, also called FiLaC (fistula laser closure), treats an anal fistula by passing a radial-emitting laser fibre along the tract. The laser destroys the lining of the tract and shrinks it closed from the inside, so the muscle around the anus is not cut at all. Typical duration at Iswarya Hospital, OMR Chennai: 20–30 mins. Recovery: 1–2 weeks.
This makes it especially valuable for fistulas that pass through a large amount of sphincter muscle, where a traditional fistulotomy would risk incontinence. The internal opening is closed with a stitch or a small flap at the same time.
Medically reviewed by Dr. Durai Ravi, Senior Consultant – General, Advanced Laparoscopic, Laser & Robotic Surgeon · Updated 9 October 2026
How is Laser Fistula Ablation performed?
- 1
Spinal or general anaesthesia is given.
- 2
The fistula tract is identified with a probe and gently cleaned with a brush.
- 3
Any seton previously placed to drain infection is removed.
- 4
The laser fibre is inserted through the external opening to the internal opening.
- 5
Laser energy is delivered as the fibre is slowly withdrawn, sealing the tract.
- 6
The internal opening is closed with a suture or mucosal flap and a light dressing applied.
What are the benefits of Laser Fistula Ablation?
- ✓No sphincter muscle is cut, so continence is preserved
- ✓Day-care procedure with return to work in a few days
- ✓Minimal pain and a tiny external wound
- ✓Can be repeated safely if the fistula recurs
- ✓Suitable for high and complex fistulas
How do you prepare for Laser Fistula Ablation?
- An MRI of the pelvis or endoanal ultrasound maps the fistula tract.
- A seton is often placed 6–8 weeks beforehand to drain infection and mature the tract.
- Fast for 6 hours before the procedure.
- An enema is given in the morning.
- Stop blood thinners as instructed.
What are the risks and side effects of Laser Fistula Ablation?
- Failure to heal in around 25–35% of cases, requiring a repeat or another technique
- Abscess formation if the tract seals over a pocket of infection
- Minor bleeding or discharge for a few days
- Pain at the internal opening for the first week
- Not suitable for very wide or branching tracts
Your surgeon will discuss all risks with you before the procedure and take appropriate precautions to minimise them.
What is recovery like after Laser Fistula Ablation?
- Warm sitz baths twice a day and after each bowel motion.
- Keep stools soft with fibre and fluids.
- Expect mild discharge for 1–2 weeks; use a pad.
- Avoid cycling, heavy lifting and long sitting for 2 weeks.
- Review at 2, 6 and 12 weeks to confirm the tract has closed.
Frequently asked questions about Laser Fistula Ablation
What is the success rate of laser fistula treatment?
Around 65–75% of fistulas heal after a single FiLaC session, and the procedure can be repeated. Success is higher for simple, well-drained tracts.
Why choose laser over cutting the fistula open?
Fistulotomy has a higher cure rate but divides muscle, so it is unsafe for fistulas crossing a large part of the sphincter. Laser closure preserves all the muscle, so it is the safer option for high or complex fistulas and for anyone with weak continence.
Do I need a seton first?
Often yes. A seton drains infection and creates a clean, straight tract, which improves the chance that laser closure will succeed.
When can I return to work?
Most patients are back at desk work in 2–3 days. Physical work should wait about 2 weeks.
Where can you get Laser Fistula Ablation 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.
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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.