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Related Experiment Video

Updated: Jun 14, 2025

Transcanalicular Diode Laser-assisted Dacryocystorhinostomy for the Treatment of Primary Acquired Nasolacrimal Duct Obstruction

Transcanalicular Diode Laser-assisted Dacryocystorhinostomy for the Treatment of Primary Acquired Nasolacrimal Duct Obstruction

Published on: October 13, 2017

Radially Emitting Diode Laser Closure of Transsphincteric Fistula-in-Ano.

Scott R Kelley¹, Robert A Vierkant², Jennifer M Russell³

¹Division of Colon and Rectal Surgery, Mayo Clinic, Rochester, Minnesota.

Diseases of the Colon and Rectum

|September 6, 2024

Summary

Diode laser closure for transsphincteric fistula-in-ano offers a continence-preserving treatment option. While initial success rates were 43%, failed cases could undergo delayed fistulotomy, with no new incontinence reported.

Keywords:

Cryptoglandular Fistula-in-ano Laser Radially emitting diode

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Area of Science:

Colorectal Surgery
Minimally Invasive Procedures
Laser Therapy

Background:

Shift in fistula-in-ano treatment towards preserving continence.
Radially emitting diode laser catheters used for fistula track ablation since 2011.
Previous studies report variable success rates (20%-89%).

Purpose of the Study:

To present the authors' experience with managing solitary transsphincteric fistulas.
Focus on cryptoglandular origin fistulas treated with a radially emitting diode laser.

Main Methods:

Prospective, nonrandomized, single-center trial with 12-month follow-up.
Forty-six adult patients with transsphincteric fistula-in-ano underwent diode laser closure.
Primary outcome measures: clinical healing and fistula recurrence.

Main Results:

Successful closure after one laser treatment in 43% of patients.
50% of failures allowed for delayed fistulotomy due to fistula migration.
No new or worsened fecal incontinence; complications included abscesses and fistula migration.

Conclusions:

Radially emitting diode laser closure is a viable, continence-preserving option for transsphincteric fistula-in-ano.
Procedure failures do not preclude subsequent treatments and may facilitate delayed fistulotomy.
Potential complications include abscess formation and fistula migration.