Using neoLaser for Anal Fistula Treatment

Using neoLaser for Anal Fistula Treatment

Anal Fistula

After an anal gland becomes infected, an anal fistula can develop. These unnatural tunnels typically run between the rectal wall of the colon to the outer layer of skin around the anus. They often cause significant discomfort for affected patients. There are a number of traditional treatments for anal fistulas. Depending on the location, size and anatomy of each fistula, it is very difficult to claim absolute outcomes.  

One new procedure that may be recommended by your physician, depending on individual physiology is laser ablation.  The neoLaser soft tissue diode laser may be a safe and effective alternative for many patients with certain types of anal fistula..

Concerns with Traditional Treatments for Anal Fistula

Typically, as patients prepare for anal fistula surgery, they're faced with at least one major concern. Either the recovery time is likely to be long and painful, or they're at risk of losing fecal continence. Many patients end up experiencing both problems.

Fistulotomy

Doctors often perform surgery to open up the fistula tract. This procedure is called a fistulotomy. Once the incision heals, the patient will be left with a scar, but the tunnel should be gone.

The problem with fistulotomies is that they're only a reasonable option for select patients. If the fistula passes through the anal sphincter, this procedure is usually ruled out. Cutting the sphincter can leave patients with long-term fecal incontinence.

Plus, the recovery period for a fistulotomy can be rather long. Patients are usually off work for up to two weeks, and full recovery sometimes takes around two months depending on the individual.

Sphincter-saving Measures

For fistulas that pass through the anal sphincter, doctors have to depend on alternative surgeries. Options include:

  • Advancement flap procedure: Bowel tissue is used to cover over the fistula opening.
  • Lift procedure: During the surgical procedure, the sphincter muscles are moved so the        doctor doesn't cut through them.
  • Seton technique: A surgical thread holds the fistula open to promote drainage and healing. This approach is usually paired with another treatment option.

These treatments vary in their effectiveness. For some of them, the jury is still out on whether they provide long-term success.

How neoLaser for Anal Fistula Works

Doctors now have another minimally invasive option for effectively treating anal fistulas. Laser ablation can close the tract without needing to cut it open or damage the anal sphincter.

Advanced Laser Fistula Ablation (ALFA) uses the neoLaser system. After cleaning and irrigating the tunnel, the doctor inserts a specially designed probe into the opening of the patient's fistula tract. The probe is carefully guided to the far end of the passage.

Once the probe begins to emit laser energy, the doctor guides it carefully back out of the tract. Along the way, the probe gives off a 360-degree ring of energy. This shrinks the fistula tunnel and destroys the epithelial tissue that lines it. If the fistula is associated with an abscessed gland, the laser will also treat that area.

After fully withdrawing the laser probe, the doctor can use stitches or a tissue flap to cover over the affected area and promote healing.

With the epithelial tissue no longer there, the sides of the tract will fuse together during the healing process. This will eliminate the tunnel so that it should no longer be a source of trouble for the patient.

To see a doctor treat an anal fistula with the neoLaser system, watch the video below:

Benefits of Fistula Laser Treatment

Anal fistula treatment with the neoV Laser offers several different benefits for patients and their doctors.

Effectiveness

Laser surgery for anal fistulas appears to produce good results over the long term. In one study of fistula-in-ano laser surgeries, follow-up examinations were performed one year after the procedure.

64% percent of patients were considered permanently healed after just one laser treatment. When taking into account those who had undergone a second round of treatment, whether a laser ablation or another surgery, 88% were deemed to be healed at the one-year mark.

The procedure was successful for patients with fistulas stemming from infected glands and for those with fistulas related to Crohn's disease.

Safety

During laser anal fistula surgery, there's no need to slice open the channel. Instead, the skin and surrounding tissues are allowed to remain intact. This eliminates the need to cut the anal sphincter.

In the follow-up study of patients who had undergone laser surgery, none of the participants experienced serious fecal incontinence afterward. They didn't have trouble with major gas incontinence either. A few participants did note a small amount of soiling.

Even still, these results stand in stark contrast to the reported incontinence rates of 20% to 43% after other types of fistula surgery.

Recovery Time

With a fistulotomy, the surgical wound is left open to heal from the bottom up. This can be a slow, uncomfortable process.

Fortunately, recovery after a laser ablation procedure can be quicker and less painful. According to another study on laser procedures for anal fistulas, in the first week after the procedure, patients reported an average pain level of just 3.0 on a scale of 1 to 10.

By using laser energy to ablate the fistula tract, you can close this passage without making major incisions, creating gaping wounds or slicing the anal sphincter. As a result, the neoLaser for anal fistula offers multiple benefits for your patients: a high chance of long-term success, a reduced risk of fecal or gas incontinence, and a less uncomfortable recovery period.

Contact Adler MicroMed to learn more about using the neoLaser ALFA procedure in your medical practice.
Brian Chandler

Brian Chandler