What Are Video-Assisted Treatment Methods (VAAFT) in Anal Fistula?

What Are Video-Assisted Treatment Methods (VAAFT) in Anal Fistula?

Anal fistula is a condition that significantly affects quality of life, recurs frequently, and carries a risk of complications in traditional surgeries. Thanks to modern approaches developed in recent years, especially muscle preservation and rapid recovery have become possible. One of these methods is VAAFT (Video Assisted Anal Fistula Treatment), a minimally invasive and video-assisted surgical technique for anal fistulas.

In this article, we thoroughly answer the most frequently asked questions such as what is VAAFT, how it is applied, who it is suitable for, and how it differs from classical methods.

What Is Anal Fistula?

An anal fistula is a tunnel-like structure formed by an infected abscess in the anus area leading to the skin surface. It usually develops following recurrent abscesses.

Symptoms include:

  • Constant discharge around the anus
  • Bad odor
  • Itching and irritation
  • Occasionally painful swellings

If left untreated, it may progress and lead to more complex fistula tracts.

What Is the VAAFT Method?

VAAFT, short for Video Assisted Anal Fistula Treatment, is a video-supported treatment method for anal fistulas.
Developed by German surgeon Meinero, this method allows internal visualization and treatment of the fistula using an endoscope.

Key features of VAAFT:

  • It is a closed method, involves no large incisions
  • The fistula tract is visualized internally via a camera
  • The tunnel is cleaned, cauterized, and the internal opening is closed
  • Muscle tissue is preserved, sphincter integrity remains intact

In these aspects, VAAFT offers a comfortable alternative especially for patients at high risk of complications.

How Is VAAFT Applied?

The VAAFT procedure is performed as follows:

  • Diagnosis and evaluation: The fistula tract is mapped with MRI and proctological examination
  • Insertion of fistuloscope: This special device allows internal visualization of the tract
  • Cleaning and cauterization: The tunnel is cleaned and epithelial tissue removed by cauterizing the side walls
  • Internal opening is closed: Closed with mucosal flap, stitches, or tissue adhesive
  • No drainage: As it is a closed system, there is usually no external discharge

The procedure takes approximately 30–60 minutes. It can be performed under local or general anesthesia.

What Are the Advantages of the VAAFT Method?

VAAFT has several advantages over classical surgery:

✅ Sphincter muscles are preserved → No risk of gas or stool incontinence
✅ Less pain → Minimal tissue trauma
✅ Rapid recovery → The patient quickly returns to daily life
✅ Lower recurrence risk → Fistula tract is directly visualized and cleaned
✅ Aesthetic benefit → No visible external scars

With these benefits, it is an ideal option for patients seeking non-invasive fistula treatment.

Who Is It Suitable For?

VAAFT yields successful results particularly in these patient groups:

  • Those with simple or moderately complex anal fistulas
  • Patients who have had previous classical surgery but experienced recurrence
  • Those who want treatment without risking muscle control
  • Patients avoiding treatment due to fear of surgery

However, in very complex and branched fistulas, it may need to be combined with other techniques.

What Happens After VAAFT?

  • Pain level is low
  • Usually, 1–2 days of rest is sufficient
  • Bathing and dressing changes are more comfortable
  • Complete healing is expected within 2–3 weeks
  • Recurrence rate is lower than classical surgery

Regular medical follow-up is vital for success.

VAAFT Experience at Avrupa Cerrahi

At Avrupa Cerrahi, we successfully apply the VAAFT method for anal fistula treatment using advanced technology and our experienced surgical team.

  • Personalized treatment plans
  • MRI-supported evaluations
  • Hundreds of successful cases
  • Minimal incision, maximum comfort
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