Anal fistula is a fatal disease. In most cases, the inflammatory occlusion of a proctodecal gland in the anal canal leads to the formation of a ganglion (fistula) or purulent inflammation (abscess) that runs through the sphincter muscle. In rare cases, a chronic inflammatory bowel disease can also be the cause.

Anal fistulas that have developed on the basis of an inflamed proctodecal gland can only be cured by surgery. The most important goal of this treatment is to maintain continence (no damage to the sphincter muscle) in addition to healing the fistula.

With the LCAF method (Laser Coagulation of Anal Fistula) the sphincter muscle is spared to the maximum. In the case of chronic fistulas without abscess cavity, laser coagulation is performed during the first operation. In the acute case of an anal abscess, the operation is performed in two steps (2 operations under general anaesthesia at intervals of approx. 8 weeks). During the first operation, the abscess is relieved and the fistula tract, which is very vulnerable due to inflammation, is marked with a soft silicone tube and all side passages are cleaned. In the following 8 weeks, the abscess cavities and lateral canals heal. In the second operation the tube is removed and the fistula tract is burned out with a special laser fibre.

All surgical methods that are as gentle as possible on the sphincter muscle entail a certain risk of incomplete or non-existent healing. I have been operating on anal fistulas with the LCAF method since 2012. My fistula closure rate after the 1st LCAF operation is 60%. After a second LCAF operation my closure rate increases to 80%. There is no faecal incontinence after an LCAF operation.

With LCAF, this surgical method is named independent of the company. It is also known as FiLaC™.