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Anal Fistulotomy: Before Your Surgery

What is an anal fistulotomy?

An anal fistulotomy is surgery to open and drain an anal fistula, helping the fistula to heal. An anal fistula is a small tunnel (tract) from the anal canal to a hole in the skin near the anus.

Your doctor will give you medicine to make you sleep or feel relaxed. You will not feel pain. The doctor will put a lighted tube (anoscope or scope) into the anus. He or she will be able to see the inside of the anus with the scope. Special surgical tools will be guided through the scope into the anus. The doctor will use the surgical tools to make a cut (incision) through one side of the fistula. This will open the fistula so that it can drain and heal from the inside out.

You may have gauze inside the opening of your fistula. The gauze may come out with your first bowel movement after surgery, or your doctor may tell you to remove it 1 day after surgery.

You will probably go home the same day as your surgery. Most people have very little pain after several days. But it usually takes several weeks for the area to completely heal. After the area heals, the fistula will be gone.

You will probably be able to return to work or your normal routine in 1 to 2 weeks.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse call line if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

How do you prepare for surgery?

Surgery can be stressful. This information will help you understand what you can expect. And it will help you safely prepare for surgery.

Preparing for surgery

  • You may need to empty your colon with an enema or laxative. Your doctor will tell you how to do this.
  • Be sure you have someone to take you home. Anesthesia and pain medicine will make it unsafe for you to drive or get home on your own.
  • Understand exactly what surgery is planned, along with the risks, benefits, and other options.
  • If you take aspirin or some other blood thinner, ask your doctor if you should stop taking it before your surgery. Make sure that you understand exactly what your doctor wants you to do. These medicines increase the risk of bleeding.
  • Tell your doctor ALL the medicines and natural health products you take. Some may increase the risk of problems during your surgery. Your doctor will tell you if you should stop taking any of them before the surgery and how soon to do it.
  • Make sure your doctor and the hospital have a copy of your advance care plan. If you don't have one, you may want to prepare one. It lets others know your health care wishes. It's a good thing to have before any type of surgery or procedure.

Having surgery can be stressful. This information will help you understand what you can expect and how to safely prepare for surgery.

What happens on the day of surgery?

  • Follow the instructions exactly about when to stop eating and drinking, or your surgery may be cancelled. If your doctor has instructed you to take your medicines on the day of surgery, please do so using only a sip of water.
  • Take a bath or shower before you come in for your surgery. Do not apply lotions, perfumes, deodorants, or nail polish.
  • Do NOT shave the surgical site yourself.
  • Remove all jewellery, piercings, and contact lenses.
  • Leave your valuables at home.

At the hospital or surgery centre

  • Bring a picture ID.
  • Before surgery you will be asked to repeat your full name, what surgery you are having, and what part of your body is being operated on. The area for surgery may be marked.
  • A small tube (IV) will be placed in a vein, to give you fluids and medicine to help you relax. Because of the combination of medicines given to keep you comfortable, you may not remember much about the operating room.
  • You will be kept comfortable and safe by your anesthesia provider. The anesthesia may range from making you fully asleep, to simply numbing the area being worked on. This will depend on the procedure you are having, as well as a discussion between your doctor, the anesthesia provider, and you.
  • The surgery will take about 30 minutes.
  • As you wake up in the recovery room, the nurse will check to be sure you are stable and comfortable. It is important for you to tell your doctor and nurse how you feel and ask questions about any concerns you may have.

Going home

  • Be sure you have someone to drive you home.
  • For your safety, you should not drive until you are no longer taking pain medicines and you can move and react easily.
  • Arrange for extra help at home after surgery, especially if you live alone or provide care for another person.
  • You will be given more specific instructions about recovering from your surgery, including activity and when you may return to work.

When should you call your doctor?

  • You have questions or concerns.
  • You don't understand how to prepare for your surgery.
  • You become ill before the surgery (such as fever, flu, or a cold).
  • You need to reschedule or have changed your mind about having the surgery.

Where can you learn more?

Go to https://www.healthwise.net/patientEd

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Care instructions adapted under license by your healthcare professional. If you have questions about a medical condition or this instruction, always ask your healthcare professional. Healthwise, Incorporated disclaims any warranty or liability for your use of this information.