Fistula Treatment in Pune
Fistula (भगंदर) Treatment In Pune
Fistula (भगंदर) Treatment In Pune
An anal fistula is a small, abnormal tunnel that forms between the inside of the anus and the skin outside. It usually develops after an anal abscess does not heal completely. Many people feel shy to talk about this problem, but it is actually very common and can be treated well by the right specialist.
Kaizen Gastro Care, Pune, is led by Dr. Samrat Jankar, a leading fistula specialist in Pune and experienced colorectal surgeon in Pune, along with Dr. Vikrant Kale, our senior Gastroenterologist. Together, they offer complete fistula treatment, from correct diagnosis to advanced fistula surgery.
Dr. Samrat Jankar completed his MBBS from Grant Medical College and Sir JJ Hospital, Mumbai, his MS in General Surgery from Maharashtra University of Health Sciences, Nashik, and his DNB in Surgical Gastroenterology from the National Board of Examination, with further specialised training at GEM Hospital, Coimbatore. He has over 17+ years of surgical experience and has personally performed more than 5000+ fistula surgeries, along with 3000+ laparoscopic and procedures. He developed the PILTEC technique, a refined method for complex and recurrent fistula cases, and his clinical and academic work has been recognised with several awards, including Best Doctor in Pune (2025) by Outlook Magazine, a Gold Medal Fellowship from the Association of Colon & Rectal Surgeons of India (ACRSI), First Prize at FISTULACON (2021) for his LASER LIFT procedure, and the Innovative Award Paper (2019) at ACRISICON for his contribution to clinical research in surgical gastroenterology.
Dr. Vikrant Kale brings strong international training and over 18+ years of clinical experience to our team, with an MRCPI from the Royal College of Physicians of Ireland and fellowships in GI Endoscopy and Inflammatory Bowel Disease from Oxford University, UK. Many patients come to us after struggling with recurring fistula problems elsewhere, and find lasting relief through our team’s careful, technique-driven, and evidence-based approach.
If you need fistula treatment or surgery in Pune, Kaizen Gastro Care can help. offers full and advanced care for fistula problems.
What is Complex Fistula?
The Standards Committee for the American Society of Colon and Rectal Surgeons (ASCRS) divided anal fistula into simple and complex types based on the complexity of fistula, risk of recurrence, and risk of incontinence.
Simple fistula:
Simple fistulas are those that are Intersphincteric or low Transsphincteric involving less than 30% of the external sphincter where the risk of incontinence is low.
Complex fistula:
“Complex” fistulas included those with
- More than 30% sphincter muscle involvement
- Anterior fistulas in female patients
- Recurrent fistulas
- Fistula associated with preexisting fecal incontinence, inflammatory bowel disease, or prior radiation.
There are several different procedures. The best option for you will depend on the position of your fistula and whether it’s a single channel or branches off in different directions. Surgery aims to heal the fistula while avoiding damage to the sphincter muscles, the ring of muscles that open and close the anus, which could potentially result in loss of bowel control.
Types of Fistula in Ano
Doctors classify fistula in ano based on how the tract moves in relation to the sphincter muscle. Understanding the type helps in choosing the correct surgery.
- Intersphincteric fistula – This tract stays between the inner and outer sphincter muscle. It is usually simpler to treat.
- Transsphincteric fistula – This tract crosses through both sphincter muscles. It needs a more careful surgical approach.
- Suprasphincteric fistula – This tract goes above the sphincter muscles before coming out through the skin. It is considered a complex type.
- Extrasphincteric fistula – This tract goes completely outside the sphincter muscle. It is rare but needs specialised treatment.
- Horseshoe fistula – This tract curves around the anal canal and connects two external openings, forming a shape like a horseshoe.
Most fistulas begin from an infected gland inside the anus. This common type is called a cryptoglandular fistula, and it accounts for the majority of the cases we see at our clinic.
What symptoms does anal fistula surgery address?
What is Fistula in Ano?
फिश्टूला (भगंदर) म्हणजे काय?
Fistula surgery is done to relieve troubling symptoms and prevent complications. Common symptoms include:
- Constant pain near the anus, often worse while sitting
- Swelling and redness around the anal opening
- Pus or blood discharge from a small opening near the anus
- Foul smell due to discharge
- Skin irritation from constant leakage
- Fever, in case of an active infection or abscess
- Repeated abscess formation in the same area
Surgery removes the fistula tract, drains any infection, and helps prevent the problem from returning.
Common Causes of Anal Fistula:
Most anal fistulas begin as a small infection inside the anal gland. Common causes and risk factors include:
- Anal Abscess – Most fistulas start as an infected abscess that does not heal fully.
- Crohn’s Disease – This inflammatory bowel condition increases the risk of chronic anal fistula.
- Tuberculosis – In India, TB is a known cause of anal fistula, especially recurrent ones.
- Prior Anal Surgery – Previous surgeries can sometimes lead to fistula formation.
- Diabetes – Poor wound healing in diabetics increases the risk of infection and fistula.
- Sexually Transmitted Infections – Can sometimes cause perianal infection and fistula.
- Radiation Treatment – Pelvic radiation can rarely lead to fistula formation.
How is an anal fistula diagnosed at Kaizen Gastro Care:
Correct diagnosis is the foundation of successful fistula treatment. At Kaizen Gastro Care, we follow a thorough diagnostic process:
- Detailed Medical History – Understanding your symptoms, past infections, and any related conditions.
- Physical Examination – A careful check of the anal area to locate external openings.
- Digital Rectal Examination – Helps feel the internal opening and the direction of the tract.
- Fistula Probing – A fine probe gently traces the path of the fistula tract.
- MRI Fistulogram – Gives a detailed picture of complex or high fistulas, including their exact path and any hidden tracts.
- Endoanal Ultrasound – Used in select cases to map the sphincter muscles and fistula tract accurately.
- Colonoscopy – Recommended if Crohn’s disease or another bowel condition is suspected.
This detailed evaluation helps Dr. Jankar choose the safest and most effective treatment plan, and avoid damage to the sphincter muscles.
Is it mandatory to do MRI in Fistula?
क्या भगंदर में MRI करना अनिवार्य है?
Fistula in Ano (Bhagandar) Treatment in Pune
If you are looking for the best fistula treatment in Pune, India, surgery remains the primary and most effective option for managing fistula in ano. While some post-operative concerns like pain, bleeding, and wound healing are common, these can be well-managed with proper care and follow-up. It’s essential to discuss critical factors like incontinence and recurrence with your fistula specialist in Pune before undergoing treatment.
- Pain: Post-surgical pain is inevitable but manageable. Advanced techniques used by leading fistula surgeons in Pune can minimize discomfort. Keep in mind that no procedure is entirely pain-free.
- Bleeding: Some post-operative bleeding, such as oozing, is expected. The extent of bleeding largely depends on the wound’s condition and type of surgery performed.
- Wound Healing: The time taken for wound healing depends on the complexity of the anal fistula and the procedure used. With proper care, healing usually completes in 2-3 weeks. Choosing an experienced fistula doctor in Pune ensures better recovery outcomes.
- Incontinence: A significant concern in fistula surgery is the risk of incontinence. High or complex fistulas might require sphincter muscle cutting, increasing this risk. Consulting a skilled proctologist in Pune is vital to minimize this possibility.
- Recurrence: Despite advanced techniques, recurrence is possible. Simple fistulas treated with sphincter-cutting procedures have lower recurrence rates. However, for complex cases, sphincter-preserving surgeries in Pune may be necessary, with recurrence rates varying based on surgeon expertise and post-operative care.
Different Surgical Methods of Fistula Treatment at Kaizen Gastro Care:
Renowned fistula surgeons in Pune, India offer two main categories of surgery for treating fistulas:
- Sphincter-Cutting Surgery: Ideal for simple, low-risk fistulas with minimal incontinence risk, this method is widely recommended by experts in anal fistula treatment in Pune.
- Examples: Fistulotomy, Fistulectomy, Cutting Seton (Ksharsutra)
- Ksharsutra Treatment: This is a traditional Ayurvedic method that uses a special medicated thread. The thread is placed through the fistula tract and changed periodically until the tract heals. It is used for select low fistula cases and is well known in Indian medicine.
Fistula Plug: In certain suitable cases, a biological plug is placed to seal the internal opening of the fistula, allowing the tract to heal gradually.
- Sphincter-Preserving Surgery (SPS): Chosen for cases where incontinence risk is higher, this approach is commonly performed by experienced surgeons specializing in advanced fistula treatment in Pune. While it reduces incontinence risk, recurrence rates may vary.CExamples: LIFT, VAAFT, Laser Fistulotomy, FILAC Fibrin Plug, Fistula Plug, PILTEC
- Seton Placement – A soft thread is placed through the fistula tract. It helps drain infection and prepares the tract for further treatment, especially in high or complex fistulas.
- Advancement Flap Surgery – Healthy tissue is used to cover the internal opening of the fistula, helping it heal from within.
- Fibrin Glue Injection – A special glue is injected into the tract to seal it. This is a simple, minimally invasive option for select cases.
- Abscess Drainage (Incision & Drainage) – When an active abscess is present, it is drained first to control infection before further fistula treatment.
Fistulotomy:
The most common type of surgery for anal fistulas is a fistulotomy. This involves cutting along the whole length of the fistula to open it up so it heals as a flat scar. A fistulotomy is the most effective treatment for many anal fistulas, although it’s usually done in simple fistula where the risk of incontinence is less. This procedure is not suitable in complex fistula in ano in cases where the risk of incontinence is considered too high, sphincter preserving procedures are recommended. At KAIZEN Gastro Care, Dr. Samrat Jankar Fistula Specialist Surgeon in Pune uses a LASER as an adjunct to Fistulectomy to minimize the risk of damage to the sphincter muscle. Thus, with the added advantage of Laser, the chances of post-operative pain will be negligible.
Ligation of the intersphincteric Fistula Tract (LIFT):
The ligation of the intersphincteric fistula tract (LIFT) procedure is the best treatment for fistulas that pass through the anal sphincter muscles, where a fistulotomy would be too risky. This is a Highly efficient procedure with almost no recurrences or incontinence. Dr. Samrat Jankar, a well-known colorectal surgeon in Pune, specializes in complex fistula surgery. Moreover, he is adept in LIFT, an advanced procedure for fistula treatment in Pune. Being well-trained with the LIFT procedure under Dr. Arun Rajunasakul (pioneer of the LIFT procedure, to date, Dr. Jankar has performed more than 1000 modified LASER LIFT procedures with excellent results. Had been awarded the best video award at an international conference for the management of complex fistula.
FiLaC ( Fistula-tract Laser Closure):
It is a minimally invasive fistula-in-any surgery that keeps the sphincter intact. This technique attempts to gently remove the anal fistula by using laser energy. The flexible, all-around radiating fiber-optic probe is inserted into the fistula tract from the outside. Then the laser is slowly withdrawn. The inflammatory tissue is destroyed in a controlled manner and the fistula tract contracts. The anal gland that originally caused the fistula is inactivated.
VAAFT (Video-Assisted Anal Fistula Treatment):
Video-assisted anal fistula treatment (VAAFT) is a new minimally invasive and sphincter-saving endoscopic treatment for complex fistulas. The fistula tract and internal fistula are localized using a fistuloscope inserted through the external opening and under direct vision fistula tract is destroyed from the inside and closure of the internal opening is done by stapling or suturing or cutaneous-mucosal flap.
Advantages:
- No surgical wounds on the buttocks or perianal region.
- The internal opening is precisely located which is important in the treatment of any fistula.
- Less chance of damage to the sphincter muscle
Potential drawbacks:
- The biggest argument against VAAFT is its high rate of recurrence (~30%)
- Higher cost of treatment
FISTULA PLUG:
The fistula plug is a 100% synthetic bio-absorbable scaffold. This plug is placed in the fistula tract. Over time cells from the body migrate into the scaffold and new tissue is generated as the body gradually absorbs the plug material, leaving no permanent material in the body.
Advantages of Fistula Plug:
- No cutting involved and no operation wound. Therefore it is associated with less pain and faster recovery.
- No damage to the sphincter muscle.
Potential Drawbacks:
- Failures can occur due to the dislodgement of the plug from the fistula tract.
- The plug can get infected
- Failure of treatment can occur in 25-30% of cases
PILTEC: a modification of the LIFT procedure
Dr. Samrat Jankar an internationally recognized fistula surgeon pioneered the LASER procedure named PILTEC having the highest cure with zero incontinence rate. He had demonstrated at many surgical conferences and workshops. He had trained many surgeons in fistula treatment using the PILTEC procedure.
Choosing the Right Fistula Surgery in Pune
For simple fistulas, sphincter-cutting surgeries in Pune are preferred due to their high success and low recurrence rates. In contrast, complex or recurrent fistulas, or those with a high incontinence risk, may require sphincter-preserving techniques offered by leading proctology centers in Pune, India.
It’s essential to consult with a specialized fistula surgeon in India to determine the best surgical option based on the complexity of your condition. Expert care and personalized treatment plans ensure better outcomes and faster recovery.
Why does the Fistula recure again and again?
भगंदर (फिस्टुला) बार-बार क्यों आता है?
Why Fistula recure again and again?
Anal fistula treatment remains a challenge for surgeons owing to its persistence or recurrence. Recurrent anal fistulas after surgery are more difficult to treat as there is even more risk of re-recurrence. Now, the challenge is that, even with the availability of so many techniques, there is a high risk of recurrence of the fistula after surgical intervention depending upon the location of the fistula, the kind of procedure performed, the expertise of the surgeon, extent of disturbing anatomy of the perianal region, unexpected findings, the effect of excess fibrosis and scarring after surgery and lack of proper postoperative care in the early and late periods following the surgery. This means that fistulas can keep on coming back even after surgery.
According to Dr. Samrat Jankar, a successful fistula surgery requires proper diagnosis, a perfectly performed and reported MRI, along with the surgeon’s expertise and the method of surgery. Dr. Samrat Jankar, the best fistula surgeon in Pune pioneer of the PILTEC procedure. In almost all cases Dr. Samrat Jankar performs a single-setting surgery with a success rate of more than 98% including fistula with perianal abscess. It is not only about surgery at kaizen gastro care dr Samrat Jankar and their team provide very good postoperative care which is one of the most important components in the complete cure of fistula.
Post-operative care after fistula surgery
फिस्टुला/भगंदर की सर्जरी के बाद खुद का ख्याल कैसे रखे
Care after Fistula Surgery
- Take sitz baths (sit for 15-20 minutes in warm water with antiseptic solution) three times a day and after each bowel movement for the first few days.
- If you were given a topical ointment, place this over the anal skin and a little into the anal canal 2-3 times a day.
- Don’t worry if you have some bleeding, discharge, or itching during your recovery. This is normal.
- Avoid constipation.
- Take stool softener before bedtime every day till the wound heals.
- The use of dry toilet tissue should be avoided. After bowel movements use a jet water cleaning, if possible, followed by taking a warm bath.
- If you were given a prescription for an ointment, apply these two or three times a day at the edge of the anal opening and inside by finger (not by applicator).
- Eat a regular diet including plenty of fresh fruit and vegetables. Drink 6-8 glasses of water a day.
Connect with your surgeon if your temperature is greater than 101 degrees, significant bleeding, and unbearable pain.
Watch Our Videos:
Why Choose Kaizen Gastro Care for Fistula Treatment:
- Experienced Fistula Specialist Team: Dr. Samrat Jankar is renowned as the best fistula specialist in Pune, available at Kaizen Gastro Care, Wakad, for treating piles, fistula, and other anal diseases.
- Advanced Diagnosis and Treatment: Kaizen Gastro Care provides a full range of diagnostic tests and innovative treatments used for the diagnosis and management of different piles and anal conditions.
- Clinic Location: Kaizen Gastro Care is located at a prime Pune and PCMC location, in the Wakad area, which is central to Pune city. Patients can easily reach us using all modes of public transport.
- Leading-Edge Technology: Our clinic is equipped with leading-edge technology such as endoscopy tests, manometry, 24-hour pH monitoring, biopsy, and biofeedback therapy. We are also supported by dedicated piles specialists and nutritionists.
- A Dedicated Centre for Fistula Treatment: Kaizen Gastro Care is among the first dedicated centres for fistula and other anal disease treatment in Pune and across Maharashtra.
- A Multidisciplinary Care Team: Alongside Dr. Samrat Jankar and Dr. Vikrant Kale, our team includes Dr. Rupali Bandgar-Jankar, Consultant Gastrophysiologist and Head of the GI Motility department, who specialises in anal manometry and biofeedback therapy for post-surgery bowel function, and Dt. Bhushan Khedkar, our Gut Diet & Nutrition Specialist, who guides patients on the right diet before and after fistula surgery for faster healing.
- We Manage Your Care for the Long Term: We manage piles, fistula, and anal disease treatment for the long term, with regular follow-ups and continued care, so that recovery is complete and lasting.
Meet Dr. Samrat Jankar – Leading Fistula Specialist in Pune
Dr. Samrat Jankar is the Director and Head of the Department of GI Surgery at Kaizen Gastro Care, Pune. He is one of the most respected names in fistula treatment in Pune, with more than 17 years of surgical experience behind him. Over the course of his career, he has performed more than 1000 laparoscopic surgeries and over 5000 fistula surgeries. His areas of expertise go beyond fistula treatment and include complex hernia repair, colorectal surgery, hepatobiliary surgery, and bariatric surgery.
Dr. Samrat Jankar completed his M.B.B.S. from Grant Medical College and Sir JJ Hospital, Mumbai, in 2007. He then went on to complete his M.S. in General Surgery from Maharashtra University of Health Sciences, Nashik, in 2012, followed by his DNB in Surgical Gastroenterology from the National Board of Examination in 2017. To further sharpen his surgical skills, he also received specialised training in surgical gastroenterology at GEM Hospital, Coimbatore, one of India’s leading centres for GI surgery.
He is best known across India for developing the PILTEC technique, a sphincter-preserving method created specifically to give higher success rates in treating complex and recurrent fistula cases. His dedication to patient care and surgical excellence has been recognised through many prestigious awards over the years:
- Best Doctor in Pune (2025), awarded by Outlook Magazine’s healthcare survey, recognising his clinical dedication and surgical patient care
- Gold Medal Fellowship, conferred by the Association of Colon & Rectal Surgeons of India (ACRSI), for topping his fellowship evaluation in advanced colorectal surgery
- First Prize at FISTULACON (2021), awarded at an international ACRSI summit for the best video presentation on his LASER LIFT procedure for complex and recurring fistula-in-ano
- Best Video Award (2019), at the AMASICON conference hosted by the Association of Minimal Access Surgeons of India
- Second Best Video Presentation Award (2018), at ACRISICON, for showcasing a single-incision laparoscopic total proctocolectomy procedure for Familial Adenomatous Polyposis (FAP)
- Innovative Award Paper (2019), presented at the ACRISICON annual national conference for innovative clinical research contributions
- Young Scholar Award (2018), honoured at AMASICON after presenting his research on laparoscopic living donor hepatectomy experience within the Indian subcontinent
- Fellowship in Minimal Access Surgery (FMAS), officially awarded by AMASI in November 2019
Patients from Pimpri-Chinchwad, Wakad, Baner, Aundh, and Hinjewadi regularly travel to consult Dr. Samrat Jankar for safe, minimally invasive, and lasting fistula treatment. Many of them come after struggling with recurring fistulas treated elsewhere, and find real relief through his careful, technique-driven approach.
Request a Call Back:
If you are facing symptoms like pus discharge, swelling, or pain near the anus, please do not delay your treatment. Early diagnosis usually leads to simpler treatment and a smoother recovery.
Book your consultation with our fistula specialist in Pune, Dr. Samrat Jankar, today.
📍 Kaizen Gastro Care, Shop No. 208/209, Oriana Crest Building, Datta Mandir Road, Wakad, Pune, Maharashtra 411057 📞 097636 35252 ✉️ kaizengastrocare@gmail.com 🕐 Mon–Sat: 8 AM–3 PM & 4 PM–9 PM 🌐 www.kaizengastrocare.com
Frequently Asked Question (FAQ):
Dr. Samart Jankar is one of the best fistula specialists in Pune. He is an expert in all treatment modalities but has a special interest in minimally invasive surgeries and laser treatment.
The fistula Treatment Laser Procedure (FiLAC technique) is the best surgery having numerous advantages. Dr. Smarat Jankar’s fistula Specialist mostly recommended the Laser technique for the fistula treatment.
The cost of the Fistula treatment in Pune ranges from INR 50000 to INR 120000. Mostly the cost depends on the patient’s Age, Patient Medical Condition, Type of Treatment used, Kaizen procedures, and Post surgical treatment.
Fistula surgery isn’t more painful. You won’t be experiencing pain during this process because you will be under the effect of anesthesia. Also, Laser procedures minimize the pain.
Kaizen Gastro Care expert Dr. Samart Jankar has performed more than 5000+ fistula surgery in his surgical experience. He has reported a success rate of more than 95%.
Fistula Surgery is the only effective way to treat severe fistulas. Some alternatives to Fistula Surgery are:
- Medicines
- Fibrin glue
This is rare. A fistula tract usually does not close on its own, so most cases need surgery for complete and permanent healing.
Most fistula surgeries take around 30 to 60 minutes, depending on the complexity of the case. Many simple procedures are done as daycare fistula surgery, meaning the patient can go home the same day.
For complex cases, a combination of accurate MRI fistula mapping and an advanced technique like LIFT, FiLaC, VAAFT, or PILTEC usually gives the best and most lasting results.
It is possible in some cases, especially with complex or previously operated fistulas. But the risk becomes much lower when the surgery is done by a skilled surgeon using proper mapping and sphincter-preserving methods, like those offered at Kaizen Gastro Care.