Advanced Sphincter-Preserving Anal Fistula Treatment with Direct Endoscopic Visualization & Minimally Invasive Care
Video-Assisted Anal Fistula Treatment (VAAFT) in Brazil is a minimally invasive procedure used to diagnose and treat anal fistulas while preserving the anal sphincter. Dr. Kaiser Jr. offers VAAFT for selected cases, especially complex or recurrent fistulas, and tailors treatment based on individual anatomy. An anal fistula is an abnormal tunnel between the anal canal and the skin around the anus, often causing drainage, pain, swelling, and infection. Because it may involve the sphincter muscles, careful planning is required to maintain continence. VAAFT uses a small fistuloscope to view the tract from inside, helping identify the internal opening and any branches under direct vision. It is considered a sphincter-preserving technique, though outcomes can vary depending on fistula type. For international patients, treatment is based on a detailed individual assessment, including fistula anatomy, prior surgeries, symptoms, and overall clinical condition.
🩺 What Is Video-Assisted Anal Fistula Treatment (VAAFT)?
Video-Assisted Anal Fistula Treatment (VAAFT) is a minimally invasive endoscopic procedure for fistula-in-ano. A small fistuloscope is inserted through the external opening to directly visualize the fistula on a video screen. This allows the surgeon to map the tract, identify the internal opening, and detect any branches or diseased tissue—especially useful in complex or recurrent cases.
The fistula is then treated from inside while preserving the anal sphincter. The internal opening is managed based on the specific anatomy. VAAFT is designed to preserve continence, though outcomes vary and recurrence is still possible. It is one of several individualized treatment options used by Dr. Kaiser Jr. for complex and recurrent anal fistulas.
🩺 Types of Anal Fistula Treatment
- VAAFT (Video-Assisted Anal Fistula Treatment) – Uses a fistuloscope and direct video visualization to map and treat the fistula tract internally. It is designed as a sphincter-preserving option and may be considered particularly for complex or recurrent fistulas.
- Fistulotomy – Opens the fistula tract so that it can heal from the inside outward. It is generally considered for appropriately selected simple and superficial fistulas where the amount of sphincter muscle involved is limited.
- LIFT (Ligation of the Intersphincteric Fistula Tract) – Accesses the tract through the intersphincteric plane and closes or divides it while aiming to preserve the sphincter muscles.
- FiLaC (Fistula Laser Closure) – Uses radial laser energy inside the fistula tract to promote controlled tissue contraction and closure while limiting injury to surrounding structures.
- Advancement Flap – Uses a flap of healthy rectal or anal mucosal tissue to cover the internal fistula opening after treatment of the tract. It may be selected when sphincter preservation is particularly important.
🩺 Who Is a Good Candidate?
Video-Assisted Anal Fistula Treatment may be considered for adults who have a confirmed anal fistula and require an approach that prioritizes accurate tract identification and preservation of the anal sphincter. Dr. Kaiser Jr.’s website particularly highlights VAAFT for complex and recurrent fistulas, although treatment selection ultimately depends on individual anatomy.
✔️ Patients diagnosed with an anal fistula
✔️ Individuals experiencing persistent or recurring drainage from a fistula opening
✔️ Patients with repeated episodes of swelling, irritation, discomfort, or infection associated with an anal fistula
✔️ Individuals with complex fistula anatomy that requires detailed assessment
✔️ Individuals whose fistula tract involves or passes close to the anal sphincter muscles
✔️ Patients for whom preservation of sphincter function is an important surgical consideration
📝 Consultation & Preparation
A detailed preoperative consultation is essential because anal fistula anatomy varies widely between patients, and Dr. Kaiser Jr. selects the most appropriate treatment—such as VAAFT, fistulotomy, LIFT, FiLaC, advancement flap, or a staged approach—based on fistula classification, complexity, and prior surgical history to balance effective healing with sphincter preservation.
✔️ Detailed discussion of current symptoms and how long the fistula has been present
✔️ Review of previous abscesses, drainage procedures, fistula operations, or recurrent infections
✔️ Assessment of the location and visible openings associated with the fistula
✔️ Review of previous medical reports, imaging studies, and surgical records when available
✔️ Evaluation of medical conditions, allergies, and current medications
✔️ Assessment for active infection or an associated abscess that may require treatment
🩺 Recovery & Aftercare
Recovery after Video-Assisted Anal Fistula Treatment varies depending on fistula complexity, treatment extent, additional procedures, and overall health, and while it is designed to minimize tissue injury and preserve the anal sphincter, Dr. Kaiser Jr. notes that it may be performed as a One Day Surgery with possible same-day discharge in selected cases depending on clinical recovery and medical assessment.
✔️ Mild postoperative discomfort, tenderness, or local drainage may occur during early healing
✔️ Pain medication should be taken only according to the treating physician’s instructions
✔️ Bowel movements should be kept comfortable, with diet, hydration, or prescribed stool-management measures when advised
✔️ Strenuous physical activity should be avoided until cleared by the surgical team
🌍 Why Choose Dr. Kaiser Jr. and His Partner Hospitals for VAAFT in Brazil?
Choosing a surgeon for anal fistula treatment requires expertise in coloproctology, precise knowledge of sphincter anatomy, access to advanced techniques, and the ability to tailor procedures such as VAAFT, fistulotomy, LIFT, FiLaC, fibrin glue, or advancement flap to each patient’s fistula anatomy, complexity, and treatment history.
✔️ Experience in general surgery and proctology
✔️ More than 30 years of surgical experience according to his official professional profile
✔️ VAAFT available for selected complex and recurrent anal fistula cases
✔️ Access to multiple sphincter-preserving anal fistula treatment techniques
✔️ Individualized treatment planning instead of a one-technique approach
✔️ One Day Surgery protocols for eligible minimally invasive procedures
✔️ Surgery performed at selected hospital facilities in São Paulo and São José do Rio Preto
