How FiLaC Works
The fistula tract is identified and cleaned. A thin laser fibre is inserted into the tract. As the fibre is slowly withdrawn, controlled laser energy is delivered along the tract wall, sealing the tract from within and stimulating healing.
The procedure avoids cutting through the sphincter muscles, preserving continence.
Suitable For
- Simple intersphincteric or low transsphincteric fistulas
- Selected complex fistulas after assessment
- Patients preferring single-session minimally invasive treatment
Not typically suitable for:
- Very complex multi-tract fistulas with cavities
- Fistulas associated with active infection or abscess
- Certain anatomies where laser cannot reliably close the tract
Complex cases may benefit more from Ksharsutra, which offers stronger evidence for such presentations.
What to Expect
Before: consultation and examination, imaging (MRI fistulogram for complex or recurrent cases), basic preoperative tests.
Procedure: performed in OT under spinal or short general anaesthesia, 20 to 40 minutes, same-day discharge.
After: mild discomfort for 1 to 3 days, sitz baths from day 2, return to work 3 to 5 days, follow-up at 4 weeks, 3 months, 6 months.
Advantages
- Sphincter preservation
- Single-session
- Day-care
- Faster recovery than conventional fistulotomy
- Minimal external wound
FiLaC vs Ksharsutra
Both are sphincter-preserving. Choice depends on fistula anatomy and complexity, recurrence history, patient preferences (single session vs weekly sessions), and cost considerations. Our detailed comparison is on the Ksharsutra vs Laser Guide.