User:Dupathak

SLOFT

(Submucosal Ligation Of Fistula Tract)

It is a new sphincter conserving operation for fistula in ano devised by Dr D.U.Pathak.

In January 2014.

Fistula is a morbid problem dates back to 5000 years.

The mainstay to cure fistula involves

  • Blocking the internal opening, by ligation, mucosal advancement, LIFT and now SLOFT.
  • Eradication of infected crypto gland in the intersphincteric plane.
  • Dealing with distal tract by curettage, coring, plug, VAAFT etc.

The problem to cure fistula since ages has been the recurrence and incontinence,.

Overzealous attempts to cure causes incontinence and too much sphincter saving conservative attempts increase the chances of recurrence.

The treatment should be tailor made according to the patient and his disease.

Technique of SLOFT

  1. Identification of internal opening and giving incision in muco cutaneous junction near the internal opening.

2. Dissection of tract and ligation.

3. Dividing the tract

Level of ligation is near internal opening and superficial.

SLOFT is simple to do and it overcomes the limitations of LIFT - which cannot be done with immature tract or an abscess.

SLOFT is possible even in pre fistula stage, as it is basically ligation of the inherent anatomical structure - the anal duct.

SLOFT can be used as an adjuvant to Plug, VAAFT and Laser ablation of fistula tract.

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