VAAFT Surgery – Pain in Butt can be Fistula, Dr Ashish Bhanot gives a new lease of life to a young Afghan

New Delhi 19 Jan 2014 :A young Afghanistan male aged 35 years had developed fistula in anus four years ago, which started as small swelling around the anus. Within days, it turned into a discharging sinus. As an immediate precaution, the antibiotics course began for next three months, but all in vain. IT CONVERTED INTO FISTULA .

The patient needed urgent surgical intervention in the form of pus drainage. He stayed in the hospital for one week, daily dressings and medicines could not help him. Pus continued. His life was a misery as he could not sit and daily dressings with a foul smelling discharge. He was operated two more times in Afghanistan but nothing helped him. He was eventually persuaded to travel to Pakistan to consultant and a possible redo surgery. He got his surgery But 3rd surgery also failed Then patient decided to travel to India, he operated twice at different big hospitals in Delhi but it even these surgeries could not help him cure.

The patient recalled about his previous surgeries that, after each operation, he would return to the hospital everyday to have his wound cleaned and dressed. But each time, the pimple-like swelling, as hard as an apple, would resurface. It was so unbearable that sometimes I could not sleep properly used to wake up because of pain, not able to sit travelling and working while sitting had become very difficult.

In view of his complicated fistula doctors at different hospitals had advised him to undergo a colostomy- making a route for passing stool through the abdomen as final treatment. He was unwilling to go through with this so he travelled back to his country, losing all hope of recovery and living a normal life. One of his fellows National advised him to consult Dr. Ashish Bhanot ( he had operated for a complex fistula and had come for a follow-up consultation. Dr. Bhanot did the surgery as a day care procedure.

Patient approached Dr Ashish Bhanot who performed final surgery for him. Following the surgery, Dr. Bhanot said, “It was one of the most challenging cases as he had already been under the knife a couple of times and had curved fistula tracts that were extending more than 15 cm deep and reaching up to root of penis and pelvic bones. It was patience and a very strong desire to completely cure the disease that helped him.” A week after surgery with regular dressing and personal hygiene there were visible signs of recovery and he got cured completely within 6 weeks.

Dr. Bhanot elaborated, “Any type of surgery to treat an anal fistula faces the challenge of finding the internal opening. The body’s healing mechanism prompts a layer of epithelial cells to grow over the internal opening. It is not completely fused shut, but may become difficult to find but, the camera eliminates the blind probing of the tract and cuts the risk of false tracts being accidentally created by the surgeon. It also makes it easier to scrape out the contents in the tract. After the internal opening is identified, it is then closed. As endoscope can pass through muscles one can reach fistulas as long as 15 to 20 cms deep without cutting anal sphincters and preserving fecal continence, even after the most complex procedures. The external opening stays open for the secretions to drain out. Though there are chances of recurrence in a few cases, it is one of the most scientific approaches with lowest morbidity rates and very quick recovery. Not only that, it is tolerated by patients very well as there are no big wounds, no risk of loss of control of stool and flatus, no tightening or cutting by thread and very small dressing which patients perform by themselves” he expalined. This surgery by Dr Bhanot has again proved that Surgery is a blend of Art and Science.

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