What to Expect: Fistula Repair Procedures

Your surgeon will draw from a variety of techniques to access and repair your fistula. As nationally renowned experts in minimally invasive colorectal surgery, this means using special techniques and making the smallest incision possible.

The most common fistula repair procedure is fistulotomy surgery. If this procedure is right for you, here's what to expect:

• We give you general anesthesia, meaning you will be asleep and not able to feel any sensation during your procedure.
• We cut open the fistula tract and remove diseased tissue or drain pus. This converts the fistula from a tunnel to an open groove and allows the fistula tract to heal from the inside out.
• If you have a larger or complex fistula, you may need a special implantable drain.
• To help the fistula tract heal, we "lay open" the fistula by stitching its sides to the sides of your incision.

Other fistula repair procedures include:

• Advancement rectal flap procedure: Closing complex fistulas by covering the internal opening with your own healthy tissue
• Endoscopic fistula repair: If your fistula is in the upper part of your small intestine, we may be able to use an incisionless technique. With the help of a small flexible tube and tiny camera we pass through your mouth and esophagus (endoscope), we access your fistula and remove it. Learn more about endoscopy.
• Fibrin glue or collagen plug: In some cases, we repair fistulas by sealing them shut instead of cutting them open. After draining your fistula, we stitch the internal opening closed and seal the external opening with either special glue made from plasma protein (fibrin glue) or a plug made of collagen protein.
• Fistula clip closure: With the help of an implantable clip, we close the internal opening of your fistula. Constant pressure from the clip dries it out and promotes healing.
• Ligation of intersphicteric fistula tract (LIFT): This procedure is similar to a fistulotomy but uses an innovative technique to access your fistula and lowers the risk of damaging healthy tissue. Using a special device, widen your fistula. Several weeks later, we remove infected tissue and close the internal fistula opening.
• Seton-Assisted fistula repair: This procedure works by wrapping cotton or silk thread (fistulotomy seton) around the opening of your fistula and tightening it over time to create scar tissue. This scar tissue eventually seals off your fistula.