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In this case, the seton loop will slowly cut through tissue inside the loop while scarring behind the loop, essentially "pulling out" the fistula without surgery. This is the Kshar-Sutra method mentioned by Sushruta in ancient Indian surgical practice. The seton used to be tied with a knot. The knot is known for causing complaints.
Seton stitch – a length of suture material looped through the fistula which keeps it open and allows pus to drain out. In this situation, the seton is referred to as a draining seton. The stitch is placed close to the ano-rectal ring – which encourages healing and makes further surgery easy. [citation needed] Fistulotomy – till anorectal ring
Birkett was a member of the Council of the R.C.S. from 1867 to 1883, and Hunterian Professor of Surgery and Pathology from 1869 to 1871. He moved up through the R.C.S. ranks. He was Examiner in Anatomy and Physiology from 1875 to 1877, member of the Court of Examiners from 1872 to 1882, member of the Examining Board for Dental Surgery from 1875 ...
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A fistulotomy is the surgical opening of a fistulous tract. [1] They can be performed by excision of the tract and surrounding tissue, simple division of the tract, or gradual division and assisted drainage of the tract in a seton; a cord passed through the tract in a loop that is slowly tightened over a period of days or weeks.
Between 2004 and 2005 there was a personal experience in the similar technique by group of surgeons. That technique included coring out the intersphinteric fistula tract from the external opening to the external sphincter, excision of the intersphincteric fistula tract and suture of the internal sphincter defect through the intersphincteric plane.