Cure Fistula Permanently

• 05 Jun 2023

Why in News?

A Pune-based surgeon has developed the Distal Laser Proximal Ligation (DSPL) procedure to treat complex fistulas.

What are Fistulas?

• About:
  • A fistula is an abnormal connection between two body parts, such as an organ or blood vessel and another structure. Fistulas are usually the result of an injury or surgery. Infection or inflammation can also cause fistula to form.
  • Fistulas may occur in many parts of the body. They can form between: An artery and vein, Bile ducts and the surface of the skin (from gallbladder surgery), the cervix and vagina, the colon and surface of the body, causing faeces to exit through an opening other than the anus, etc.
• Prevalence:
  • Two million women in low-resource settings have an obstetric fistula, and 100,000 more develop one every year. Obstetric fistula is a devastating childbirth injury and a neglected public health and human rights issue.
    • Only 1 in 50 women with obstetric fistula ever receives treatment.
  • Fistula-in-ano is one of the most commonly encountered surgical problems with the prevalence of an average of 2/10,000.
• Treatment:
  • While some fistulas can be treated with antibiotics and other medication, fistula removal surgery may be necessary if the infection doesn’t respond to medication or if the fistula is severe enough to require emergency surgery.

What is Distal Laser Proximal Ligation?

• The DSPL surgery is a minimally invasive, sphincter-saving surgery for complex fistulas.
  • Sphincter is a ring-shaped muscle that relaxes or tightens to open or close a passage in the body. Examples Pyloric Sphincter (at the lower opening of the stomach)
• The surgery is based on two principles - debridement and efficient drainage from the fistula in the first two to three weeks.
• DLPL is performed under the guidance of a 3D EndoAnal Imagine machine which can identify hidden fistula tracts and micro abscess in real time during surgery.
• DLPL is associated with a negligible recurrence rate and the patient can resume work in about five days.
• According to the Indian Journal of Colo-Rectal surgery, minimally invasive, sphincter-saving DLPL surgery is a safe and effective treatment for complex fistula‐in‐ano.

What are Global Initiatives to Treat Fistulas?

• International Day to End Obstetric Fistula is observed on 23 May every year.
  • The day aims to ensure access to emergency obstetric care and skilled health professionals, especially midwives, to all women to prevent and help ensure treatment for obstetric fistula.
  • The theme of 2023 is "End Fistula Now."
• United Nations Population Fund (UNFPA) leads the Campaign to End Fistula, which works in more than 55 countries on prevention, treatment, and rehabilitation efforts.
• The United Nations Member States are invited to consult the resolution to end fistula by 2030.

Source: IE