Anal Fistulotomy Periprocedural Care

Updated: Jun 28, 2022
  • Author: Vassiliki Liana Tsikitis, MD, MCR, MBA, FACS, FASCRS; Chief Editor: Kurt E Roberts, MD  more...
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Periprocedural Care


Equipment required for anal fistulotomy may include the following:

  • Local anesthetic
  • Fistula probes
  • Methylene blue, hydrogen peroxide
  • Seton (Silastic vessel loop, suture)
  • Additional equipment, depending on the specific approach employed (fibrin glue or plug, bioprosthetic plug)

Patient Preparation

Local anesthesia (0.25% or 0.5% bupivicaine with 1:200,000 epinephrine injected circumanally and submucosally) with intravenous sedation can be used. General anesthesia may be required for airway control issues.

The patient is placed in a prone jackknife position, with the buttocks gently taped apart to afford better exposure.