Can Laparoscopic Surgeries help in management of fistula tracts? - Dr. Nagaraj B. Puttaswamy скачать в хорошем качестве

Can Laparoscopic Surgeries help in management of fistula tracts? - Dr. Nagaraj B. Puttaswamy

Laparoscopic surgery or earlier we were calling it as laparotomy. Laparotomy is cutting open the abdomen to see what is inside. Laparoscopy is looking into the abdomen with the help of scope. It is a scope. It may be 3mm, 5mm, 10mm, depending on whatever material we use, we try to see into the abdominal cavity. There is no role of the Laparoscope in the management of the fistula. But we have more scope where we try to see the internal passage, the lumen of the fistula which will be connecting from the skin of the internal organ, say the perianal fistula, where the fistula will be connecting from the anal canal to the outside associated skin. So we try to do an associated surgical procedure with the help of a scope. That we call as the VAAFT procedure, visually assisted fistula tract ablation. So in this procedure, we try to insert the fistula with the help of irrigation material, to expand the fistula, to try to see the fistula, even if it is complex, if there is diversion, if multiple branches tare there, all the branches can be easily approached this and from one side we try to ablate the fistulous tract, thus technique wilt try to maintain the continence which is possibly damaged with the conventional type of fistulas. VAAFT procedure is don’t for high level fistulas. Low level fistulas are there, which are connecting the lower part of the anal canal, which are connecting the anal canal beyond the level of the sphincters. During a conventional procedure, we have a tendency to damage the sphincters. In a conventional procedure, we tend to damage these sphincters. To avoid these procedures, we avoid conservative procedures called as set on insertion and we try to tighten the set on insertions , we try to do this procedure on a regular basis. But otherwise it is relatively painful and cumbersome procedure when compared to VAAFT which is very advanced. It is called as endoscopic management of fistula surgery. There is nothing called as laparoscopic management of fistula surgery procedure.