Video-Assisted Anal Fistula Treatment (VAAFT): Johor Bahru’s Humble Beginnings

Background: Anal fistula is an abnormal tract communicating between the perianal region to the anal canal and occasionally to the lower rectum.video-assisted anal fistula treatment (VAAFT) is an upcoming minimally invasive technique to treat fistulas Aim: To describe the technique and our initial experience with video-assistance for anal fistula treatment.Technique: A Karl Storz video equipment was used.Main steps included the visualization of the fistula tract using the fistuloscope, the correct localization of the internal fistula opening under direct vision, endoscopic treatment of the fistula and closure of the internal opening.Results: Mean operative time is 39 minutes.Internal fistula opening could be identified in 3 patients after complete fistuloscopy.The mean pain score observed is 3 using the numeric pain score.There were no intraoperative or postoperative complications.During due course of follow-up, it was observed that in 37.5% of patients had non-resolving symptoms.Conclusion: Video-assisted anal fistula treatment has less morbidity post-operatively.It enables direct visualization of the fistula tract, internal opening and secondary paths.