sloft technic
TRANSCRIPT
SLOFT (Submucosal Ligation Of Fistula Tract)
Dr D.U.PathakWhatsApp 94251-52747
Email : [email protected] hospital, Jabalpur
(M.P) India
Inter sphincteric fistula at 2- O clock
• External opening at 2-O clock • Tract palpable up to 3
cms
Probing
• Gentle probing• Probe pulled out of anal
canal
Injection
• Inj Xylocaine adrenaline at muco cutaneous junction, just 1 cm beyond the internal opening, for hydro dissection and blanching
Incision
• At muco cutaneous junction
Dissection around the probe
• Dissection around the indwelling probe with artery forceps
• Passing an aneurysm needle and taking suture with it’s help
Tying the tract
• The probe is taken out and tract tied, transfixed
Transection
• Tract is cut near to the tie
• A lateral segment, which is infected crypto-glandular portion, is excised and sent for biopsy
Dye test
• After transecting the tract, dye is instilled from external opening, which comes out from perianal area instead of anus
• Cotton squab in anus is seen without soiling with dye
Coring
• Coring is done of distal tract if it is mature.
• Otherwise only curetted, if it is an abscess fistula complex with tract not well formed
• The external epithialised opening should remain patent to drain the infection
Perianal wound closed
• Should be left open with a small pack if inter sphincteric space is infected
• If the tract was mature and total excision was possible then it can be closed primarily
External opening wound
• Loose packing done for one day
• No post op packing or dressings, only cleaning and warm sitz bath is enough
• Post operative follow up after 15 days or SOS if patient has any problem
• P/R and a check USG is done on 15th day to see for any collection if any and further visits decided accordingly
Thanks...
I am happy with the results...