METHOD FOR MINIMALLY INVASIVE TREATMENT OF TRANS- AND EXTRASPHINCTER PARARECTAL FISTULAS Russian patent published in 2023 - IPC A61B17/00 A61B18/22 A61P31/02 

FIELD: medicine; coloproctology.

SUBSTANCE: surgical exploration of the fistulous passage through the external opening is carried out. The fistulous passage is washed with a 0.05% aqueous solution of chlorhexidine, followed by treatment of the passage with a Volkman spoon and ablation with a Lakhta-Milon surgical laser intraluminally using a light guide with circular radiation with a wavelength of 1,470 nm, a power of 9 W, at a speed of 1 mm/s. In the longitudinal direction, two incisions bordering the internal fistulous opening are excised as a single block of the mucosa together with the submucosal layer and the opening to the muscular layer of the internal sphincter. The resulting defect after treatment with a 0.05% aqueous solution of chlorhexidine is sutured by applying a Z-shaped suture to the internal fistulous opening with the capture of the muscle of the internal sphincter. The same thread is continuously sutured with screwing sutures of the rectal mucosa in the longitudinal direction.

EFFECT: method allows to atraumatically remove the epithelial lining of the fistula and hypergranulation without the damage to the sphincter does not lead to tissue deficiency, reduces treatment time, prevents disease recurrence and postoperative complications, and improves cosmetic results.

1 cl, 1 ex