biolitec® in Coloproctology

Minimally invasive laser therapy of anal fistula


Dr Hartmut Lorenz: Shut down the "fox's house" from the inside - With laser in branched tracts

In an interview: Dr. Hartmut Lorenz, specialist for vascular and visceral surgery and proctologist as well as senior physician at the Venoproct practice clinic at the Schlosspark Klinik Ludwigsburg. He treats rectal diseases such as anal fistulas with the laser from the inside out.

Dr. Lorenz, what are anal fistulas?
Anal fistulas begin as inflammations in the rectal area and can form tubular connections to the skin surface in the anus region. These connections, i.e. fistulas, are supposed to transport the pus away and are also called "fox's house". The so-called fox's house occurs particularly often in anal fistulae, which are caused by the chronic intestinal disease Crohn's disease.

How do anal fistulas manifest themselves?
Typical symptoms are anus itching, burning, pain after bowel movement and a possible weakness to hold the intestinal contents, i.e. fecal incontinence. Patients often observe pus and faecal traces on their underwear. An unpleasant smell can also occur in the intimate area.

Do anal fistulas disappear by themselves?
Unfortunately not. An anal fistula does not heal on its own. If the inflammation is not treated, it even threatens to spread further and the discomfort and pain increase.

How to get rid of anal fistulas?
Traditionally anal fistulas are often removed very easily by splitting. If a branched duct system has developed through the sphincter muscle, the treatment of anal fistulas is more difficult. Excessive intervention during the surgical procedure threatens incontinence and the probability of recurrence is still around 30 percent. Here, laser treatment with closure of the inner fistula mouth is a good treatment option.

How exactly does the laser procedure work?
At Venoproct we use the gentle FILaC® laser procedure from biolitec®. After local anesthesia or short anesthesia, an innovative laser probe is carefully inserted from the outside into the inflamed pus duct and guided to the focus of inflammation. The laser pulses heat the tissue. When the laser probe is slowly retracted, the anal fistula is closed step by step from the inside, like a zipper. The surrounding tissue remains unharmed.

How long does the laser treatment take?
Since the innovative laser probe is very flexible and can be used with any type of anal fistula - regardless of how long the "foxhole" is, we only need an average of 30 minutes. The wound that occurs during the incision-free procedure is smaller and the healing process is better. There are fewer side effects and less postoperative pain. The patient is more quickly fit again for everyday life.