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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
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.
LIFT technique is the novel modified approach through the intersphincteric plane for the treatment of fistula-in-ano, known as LIFT (ligation of intersphincteric fistula tract) procedure. LIFT procedure is based on secure closure of the internal opening and removal of infected cryptoglandular tissue through the intersphincteric approach.
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Either procedure is relatively safe with risks and healing much like a subdermal implant in any other part of the body, although, like many genital piercings, the generous blood flow to the genitals can reduce healing times considerably. Inflammation is very common, during and after healing, although careful healing can minimize this.
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