Laser fistula surgery [Filac]: When and how?

Gorgun E., ŞENGÜN B.

SEMINARS IN COLON AND RECTAL SURGERY, vol.30, no.4, 2019 (ESCI) identifier identifier

  • Publication Type: Article / Article
  • Volume: 30 Issue: 4
  • Publication Date: 2019
  • Doi Number: 10.1016/j.scrs.2019.100706
  • Journal Indexes: Emerging Sources Citation Index (ESCI), Scopus
  • Keywords: anal fistula, surgical treatment, sphincter preserving, laser, FiLaC, PERIANAL FISTULAS, CROHNS-DISEASE, IN-ANO, ABLATION, CLOSURE, EXPERIENCE, MANAGEMENT, TRACT
  • Istanbul University Affiliated: No


Anorectal fistula repair is still one of the most challenging conditions treated by surgeons. Despite modern advances in surgical care, failure rate of surgical treatment exceeds 30%. One of the challenges that surgery cannot properly address is the obliteration of the fistula tract epithelium. Another challenge is the treatment of high fistulas which involve significant portion of the anal sphincter muscles. Unfortunately, surgical treatment of these fistulas may cause long term anal incontinence in some of the patients. Fistula-tract Laser Closure (FiLaC (TM), Biolitec AG, Jena, Germany) was developed to overcome these issues, by using a radially energy emitting laser probe that obliterate the epithelial tract while closing the defect without causing any damage to the sphincters. Up to date, 11 studies have been published with promising results. In this review, we will be evaluating the indications, the technical steps, short and long-term results of laser fistula surgery. (C) 2019 Published by Elsevier Inc.