What Is VAAFT and Why It Matters | Dr. Tarun Mittal
What Is VAAFT and Why It Matters
Video‑Assisted Anal Fistula Treatment (VAAFT) is a minimally invasive, sphincter‑preserving procedure introduced in 2006. It uses a special device called a fistuloscope—a tiny camera inserted through the external opening of the fistula. This allows the surgeon to see the fistula tract from inside, clean it thoroughly, cauterize it, and then close the internal opening.
This is a major advancement over traditional procedures like fistulotomy, which often involve cutting through sphincter muscles and carry a risk of incontinence.
VAAFT has two main phases:
Diagnostic phase: Identifying the complete tract and internal opening.
Operative phase: Cleaning, cauterizing, and closing the internal opening with sutures, a flap, plug, or glue.
✅ Effectiveness: How Well Does It Work?
What Studies Show
In complex fistulas, studies report about 89% complete healing, with most cases healing after one or two sessions.
Other large analyses show success rates around 76–83%, low complication rates (under 5–11%), and very minimal impact on continence.
Average operating time is about 45 minutes, with patients often staying in the hospital for 1–4 days.
Summary: VAAFT has shown strong results worldwide—high healing rates, low recurrence, quick recovery, and very low risk of incontinence.
Comparison to Traditional Surgery
In studies comparing VAAFT to traditional fistula surgery:
Shorter surgery times and less blood loss.
Lower pain scores in the days after surgery.
Quicker return to work and normal life.
Much lower rates of incontinence compared to seton or cutting procedures.
Recurrence rates are similar, sometimes slightly higher in very complex cases, but often still acceptable considering the lower risks.
🤔 Safety, Recovery & Side Effects
Complications are rare and usually minor, like mild bleeding or infection.
Continence is usually preserved; most patients report no worsening.
Recovery is generally quick: many patients go home within 1–2 days and return to light work within 1–2 weeks.
Multiple sessions: Some complex fistulas may need a second procedure, but this is still less invasive than traditional surgery.
Limitations
Success depends on the fistula type and the surgeon’s experience.
In some cases, the surgeon may miss tiny secondary tracts, which can lead to recurrence.
Costs can vary depending on hospital and complexity.
📍 VAAFT in Delhi: What to Expect
Delhi offers many skilled colorectal and GI surgeons experienced in VAAFT. Both private hospitals and some large public hospitals now offer this technique.
Pre‑surgery:
A detailed MRI scan is usually done to map the fistula.
A consultation with a colorectal surgeon to discuss the plan.
Procedure:
Usually takes around 45–90 minutes.
Done under general or spinal anesthesia.
Many patients stay in the hospital for only 1–2 days.
Recovery:
Mild pain in the first few days, usually controlled with medication.
Follow-up visits to check healing and clean the tract if needed.
Full healing can take several weeks to months.
👂 What Patients Say
Patient stories often reflect the clinical data:
Many describe less pain and faster recovery compared to earlier procedures they had tried.
Some had complete healing in a few weeks.
Others needed a repeat procedure but still found it easier than traditional surgery.
Overall, most appreciate the lower risk of incontinence and the minimally invasive nature.
“The procedure was quick, the pain was much less, and I was able to get back to normal life faster.”
“I needed a second VAAFT session, but even then it was easier than the older surgeries I’d tried before.”
💡 Tips for Patients in Delhi
Choose an experienced surgeon: Outcomes depend greatly on skill and experience.
Ask for MRI mapping: To see the full complexity of your fistula.
Discuss combination treatments: Some surgeons use VAAFT with plugs, glue, or clips for better results.
Be patient: Healing may take weeks, even after a successful procedure.
Prepare for follow-up: Regular dressing changes and monitoring are important to prevent recurrence.
Final Thoughts
VAAFT is a modern, minimally invasive, and highly effective option for treating anal fistulas, especially complex types. It offers:
Around 80% success rates in large studies.
Quick recovery and less pain.
Very low risk of incontinence, preserving quality of life.
In Delhi, with many advanced hospitals and trained surgeons now offering this technique, patients can access world-class care closer to home. While some cases may need more than one session, most patients experience significant improvement and a better recovery experience compared to traditional methods.
If you’re suffering from a complex anal fistula, VAAFT is certainly worth discussing with a trusted colorectal surgeon.
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