A novel device for minimally invasive ‘core-out’ fistulectomy of high fistula-in-ano

Abstract

Purpose: With the aim of facilitating core fistulectomy of high fistula-in-ano and reducing the risk of harmful injuries to sphincter muscles, we fabricated a novel fistulectomy set. Methods: The set circumferentially separates approximately 2.5 mm thickness of the tract by moving a special tubular blade along it and removes the separated tissues by rotating a special cannulated screw which is housed in the blade. A straight rigid probe is used for identifying the tract path and guiding the device along it. Results: We used this set for circumferential excision of fistula models created in cubic pieces of fresh cow muscle with excellent results. Conclusions: With regard to results of our tests, it is anticipated that the new set will provide significant advantages in treatment of high anal fistulas, namely noticeable reduction in the diameter of fistulectomy lumen, reducing the injuries to anal sphincters, minimizing the risk of faecal incontinence and shortening the convalescence period.

Keywords::

• Anal fistula
• Core-out
• Faecal incontinence
• Fistulectomy
• Minimally invasive surgery

Acknowledgements

The authors thank the Iran National Science Foundation (INSF) for providing the financial support for this project.

Declaration of interest: M. Esmaeili, S. Najarian and S. M. Towliat Kashani report no declarations of interest.