(An advanced Ksharsutra technique for management of fistula in ano).
Fistula in ano is most notorious disease among all the ano-rectal disorders since antiquity. Over the past few decades, various techniques are being evaluated in terms to prevent its recurrence and complications, but despite more than two millennia of efforts, fistula in ano still remains a perplexing surgical disease.
The sign and symptoms of fistula in ano resembles with Bhagandara described in Ayurveda classics. For the management of this painful disease many treatment modalities are enumerated in Ayurveda classics and Ksharsutra therapy is one among them which is proved to be gold standard. Though Ksharsutra therapy is big revolution in the field of fistula in ano, but it has some disadvantages like it is time consuming process, severe post-procedural pain, big scar marks.
Aim of the technique is to eradicate the infected anal crypt with minimal damage to anal sphincter by using kshara sutra( use of kshara sutra causes extensive fibrosis and favours proper healing which reduces the chance of recurrence
In this technique interception of the proximal part of the fistulous tract is done at the level of external sphincter along with the application of kshara sutra from the site of interception to the infected anal crypt in the anal canal.