Proctology · PuneNABH accredited4.9 · 12k reviews

Anal Fistula Surgery in Pune

Also known as Minimally-invasive proctology surgery

Sphincter-sparing technique, low recurrence. A laser / vaaft approach with same-day discharge and a typical recovery of 2–3 days. But surgery is the last step, not the first — start with a proctologist and rule out the simpler fixes.

TreatsBleedingProlapsePainFissureFistula
Written from standard clinical references · Awaiting review by a qualified clinician · Updated Jul 2026
Laser
Approach
Zero
Cuts · stitches
Same day
Discharge
2–3 days
Back to work
All insurances accepted
No-cost EMI available
Same-day discharge
Free post-op follow-ups
Consultation first — surgery only if needed

How it works

You don't buy an operation here — you start with a doctor. Book a consultation first; Anal Fistula surgery happens only if a proctologist confirms you need it.

1
Book a ₹750 consultation
Meet a Meridian Health proctologist — in-clinic or on video. They examine you and review any reports you bring.
2
Get an honest verdict
Many cases settle with medication, lifestyle changes or a minor step. You're advised surgery only if you truly need it.
3
If surgery is advised
Your ₹750 consultation is adjusted into the surgery cost. We handle insurance approvals and scheduling.
4
Day-care laser surgery
The laser / vaaft procedure with same-day discharge, and free post-op follow-ups until you've fully healed.
Understand it first

About anal fistula (fistula-in-ano)

An anal fistula is an abnormal track running between the inside of the anal canal and the skin near the anus. It usually begins as an infection of an anal gland that forms a perianal abscess; when the abscess drains, a track is left behind and keeps discharging. Fistulas are classified by how much of the anal sphincter muscle they cross — intersphincteric, transsphincteric, suprasphincteric, extrasphincteric — and that anatomy, not the size of the opening, decides which operation is safe. The thing being protected in every one of those decisions is continence.

Common symptoms
Persistent or intermittent discharge of pus or blood staining underwearA small opening, pimple or bump in the skin near the anusRecurring swelling and pain that eases when it dischargesIrritation and excoriation of the surrounding skinFever and severe pain if an abscess re-forms
What causes it
A previous perianal abscess — much the commonest cause
Crohn's disease
Tuberculosis
Previous anal surgery or an obstetric injury
Hidradenitis suppurativa; rarely radiation or malignancy
The four grades
1Grade 1
Small internal swelling, no prolapse — often just bleeding.
2Grade 2
Prolapses on straining but slips back on its own.
3Grade 3
Prolapses and must be pushed back manually.
4Grade 4
Permanently prolapsed and cannot be pushed back.
See a doctor if symptoms persist, worsen or keep returning. Early treatment is simpler and avoids complications.
Surgery is not the first step

When is surgery actually needed?

A fistula almost never closes on medicine alone. Antibiotics settle the surrounding infection but they do not heal the track, so conservative care here means draining an acute abscess, sitz baths and skin protection while the inflammation quietens — it is preparation, not an alternative. The definitive step is surgical, and it is timed once the acute sepsis has settled. An MRI fistulogram or endoanal ultrasound maps the track, its branches and its relation to the sphincter before anything definitive is done; skipping that mapping is how continence gets damaged. If Crohn's disease or tuberculosis is behind the fistula it has to be treated medically alongside, or the repair will fail whatever the technique.

The technique

Why laser, not open surgery

VAAFT (video-assisted anal fistula treatment) passes a fine fistuloscope along the track under direct vision, so the internal opening and any side branches are actually seen rather than probed for. The track is cleaned and cauterised and the internal opening is closed — the sphincter is never divided. Laser closure (FiLaC) works on the same sphincter-sparing principle, delivering radial energy along the track so the wall shrinks and seals. The trade-off is explicit: preserving the muscle accepts a higher chance of the track recurring than laying it open does.

Compare
Laser / VAAFT (day-care)
Open surgery
Cuts & stitches
No open wound, no stitches
Large incision with stitches
Anaesthesia
Spinal / local anaesthesia
General / spinal, longer
Hospital stay
Same-day discharge
2–3 days admitted
Post-op pain
Minimal
Significant for days
Bleeding
Very little
Moderate
Back to work
2–3 days
2–3 weeks
Recurrence
Low
Higher

Your options for anal fistula (fistula-in-ano)

Non-surgical options are listed first where they exist. Which one suits you depends on your examination and reports — this table is here so you can ask better questions, not to choose for you.

Option
Stay
Recovery
What it is for, and the trade-off
Abscess drainage + antibiotics
Same-day discharge
1–2 weeks
Treats the acute infection and nothing else. The track remains and will keep discharging.
Fistulotomy (laying open)
Same-day discharge
2–4 weeks with an open wound
The highest healing rate, but it divides muscle — only for low tracks crossing little sphincter.
Seton placement
Same-day discharge
Weeks to months with the seton in place
A draining or cutting thread. A staged step for complex, high or actively infected tracks — not a one-visit cure.
VAAFT
Same-day discharge
2–3 days
Endoscopic and sphincter-sparing, and it finds branching tracks under vision. Needs specific equipment and training.
Laser closure (FiLaC)
Same-day discharge
2–3 days
No open wound, sphincter preserved. Best for a single well-defined track; a repeat session is sometimes needed.
LIFT or advancement flap
1 day
1–2 weeks
Sphincter-sparing options for transsphincteric tracks. Choice depends on anatomy and the surgeon's experience.
You choose the doctor

Our proctologist surgeons

Dr. Imran Sheikh

Dr. Imran Sheikh

Senior
MBBS, MD, DM (Gastroenterology)
4.816 yrs exp
Endoscopy · Liver & pancreas
Next slot: This week · 6:30 PM
Dr. Vivek Rao

Dr. Vivek Rao

Senior
MBBS, MD, DM (Gastroenterology)
4.715 yrs exp
Endoscopy · Liver & pancreas
Next slot: Tomorrow · 10:00 AM
Dr. Sanjay Kulkarni

Dr. Sanjay Kulkarni

Senior
MBBS, MS (General Surgery)
4.820 yrs exp
Laparoscopic & GI surgery
Next slot: Today · 4:30 PM
Dr. Arjun Menon

Dr. Arjun Menon

Senior
MBBS, MD, DM (Neurology)
4.718 yrs exp
Stroke care · Epilepsy
Next slot: Tomorrow · 12:30 PM
Transparent pricing

Cost, EMI & insurance

Anal Fistula surgery — all-inclusive package
55,000 – ₹70,500
No-cost EMI from 4,600/month over 12 months.
Your ₹750 consultation is deducted from this package.
Included
Surgeon, anaesthetist & OTLaser procedure & consumablesDay-care room & nursingMedicines during the stayFree post-op follow-ups
Billed separately
Pre-op tests (₹2,000–5,000)Stay beyond the packageUnrelated conditions

Covered by insurance

Anal Fistula surgery is covered by most health policies. We start cashless pre-authorisation before admission — you pay nothing extra at discharge.

Star HealthHDFC ErgoICICI LombardNiva BupaCare HealthTATA AIGAditya BirlaCGHS / ECHS
What to expect after

Your recovery timeline

Day 0
Surgery day
Home with same-day discharge. Light diet, prescribed pain relief and gentle movement encouraged.
First week
Back to routine
Most patients return to desk work within 2–3 days. Simple aftercare speeds healing.
By 2–3 days
Fully recovered
Normal activity and exercise resume around 2–3 days. A free follow-up confirms complete healing.

Week by week after anal fistula surgery

Day 0

Home the same day with a small dressing. Some ooze from the external opening is normal and expected.

Day 1–3

Discharge continues, sitz baths two or three times a day, dressings changed. Desk work usually resumes.

Week 1–2

Discharge reduces markedly and the external opening starts to close. Keep stools soft.

Week 4–6

The track heals. Follow-up examines for a residual opening — healing is judged on examination, not on how you feel.

3–6 months

The window in which a recurrence, if there is going to be one, usually declares itself.

The honest part

Risks, preparation & aftercare

Every operation carries risk. These are the complications your surgeon will take you through before you consent — they are listed here so you read them without a pen in your hand.

Possible complications of anal fistula surgery

Recurrence or a persistent track needing a second procedure — the main one, and higher with sphincter-sparing techniques
Impaired continence, from loss of control of flatus to soiling, if sphincter muscle is divided
Bleeding
Infection or a fresh abscess
Delayed healing, particularly in smokers, diabetics and in Crohn's disease
Anaesthetic risks

Before your procedure

MRI fistulogram or endoanal ultrasound to map the track. Fitness bloods and an infection screen. Blood sugars optimised if you are diabetic — healing here depends on it. Stop smoking. An enema on the morning, nothing to eat for 6 hours and clear fluids up to 2 hours before. Blood thinners reviewed with the prescribing doctor.

After you go home

Sitz baths two or three times a day and after every bowel movement, then dry the area properly and change the pad. A laxative to keep stools soft. Finish any antibiotic course prescribed. Report fever, increasing pain, swelling or fresh pus. Attend the review at two and six weeks — a fistula is declared healed by examination, not by the absence of symptoms.

Good to know

Frequently asked questions

+

Start with a conversation, not a commitment.

Book a ₹750 consultation with a proctologist — adjusted into your surgery cost if you go ahead. No pressure, no surgery unless you need it.

Related procedures

750 consult
Adjusted into surgery cost