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Procedure Name

Endoscopic Gastrointestinal Fistula Surgery
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Surgery Type

Minimally Invasive Procedure
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Hospital Stay

1 to 3 Days
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Duration of Surgery

1 to 3 Hours
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Type of Anaesthesia

General Anesthesia
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Full Recovery

4 to 6 Weeks

What Are Gastrointestinal Fistulas?

Gastrointestinal fistulas are abnormal openings in your digestive tract. They occur due to an abnormal fluid or pus build-up in your abdominal cavity. The gastric and intestinal juices and contents leak through these openings into different parts of your body, leading to untoward complications.

Gastrointestinal fistulas are often seen in people who have had surgery on their abdomen. If you suffer from chronic digestive tract diseases like Crohn’s, diverticulitis, and abdominal tuberculosis, you are at a high risk of developing gastrointestinal fistulas. There can be 4 types of fistulas:

  1. Intestinal fistulas: Also called gut-to-gut fistulas. The gastric fluid leaks from one part of the intestine to the other.
  2. Extra-intestinal fistulas: The gastric fluid leaks from the intestine to other organs like the bladder, lungs, etc.
  3. External fistulas: The gastric fluid leaks through the skin, hence also known as a cutaneous fistula.
  4. Complex fistula: This type of fistula can occur in more than one organ.

Diarrhea, chronic malnutrition, and weight loss are the major symptoms of gastrointestinal fistulas. Small-sized fistulas usually heal on their own. Treatment for gastrointestinal fistulas includes medications like antibiotics and immune suppressants. Surgery is recommended if your condition has not improved after 3 to 6 months of treatment.

What Is Endoscopic Gastrointestinal Fistula Surgery?

Gastrointestinal fistula surgery is the surgical way of treating fistulas. This method is the last resort when the fistulas are not healing even after 3 to 6 months of conventional treatment.  Endoscopic gastrointestinal fistula surgery is a minimally invasive procedure performed with the use of an instrument called an endoscope. 

This surgery aims to cut open the fistula, drain the contents out, and perform repair work to ensure gastrointestinal tract continuity and optimal functioning. Depending on the location of the fistula, the surgery can be of two types:

  • Upper GI endoscopic fistula closure: This type of surgery is helpful in cases where the fistula is in the esophagus, stomach, and small intestines. The endoscope is inserted through the mouth.
  • Lower GI endoscopic fistula closure: This surgery is helpful in fistulas in the lower gastrointestinal (GI) tract i.e., in the large intestines, colon, and rectum. In these, the endoscope is inserted through the anus.

Endoscopic gastrointestinal fistula surgery is an outpatient procedure, meaning you can go home the same day. Endoscopic gastrointestinal fistula surgery is preferred as there are fewer chances of infections and a quicker recovery rate.

When Is Endoscopic Gastrointestinal Fistula Surgery Recommended?

Surgical repair is usually the last resort in fistula treatment. Endoscopic fistula repair is recommended in people:

  • Who have shown no response to medical treatment for more than 6 months
  • In whom the condition is progressively worsening. 
  • In whom the fistula has grown large and has become infected
  • Who have developed a complication like sepsis

How To Prepare For An Open Gastrointestinal Fistula Surgery?

Surgical repair of a fistula is usually done as a last resort. It is recommended when the symptoms are very severe and you have not been responding to treatment for more than 3 to 6 months. Remember a few points before you go in for this surgery. Here is how you can prepare yourself to get your fistula surgically fixed.

  • You can ask your surgeon to explain the details of the procedure along with the outcome and prognosis. You will be asked to sign an informed consent form agreeing to proceed with the surgery.
  • Discuss your medical history with your surgeon and inform him about-
    • All the medications that you are currently taking for your health conditions
    • Any dietary supplements and herbs that you are taking
    • Allergies towards medicines, if any.
  • You will be advised of certain tests before you go in for surgery. These include routine blood tests and imaging tests like CT scan, MRI, USG scan, Fistulogram, etc. 
  • You will be asked to stop medications like blood thinners (to prevent excessive bleeding during and after surgery) a week before surgery.
  • You will be advised of dietary precautions before surgery.
    • If you are undergoing lower GI endoscopic fistula repair, you will be asked to follow a liquid diet. A laxative or enema may be prescribed.
    • If you have been suggested an upper GI endoscopic fistula repair, you will be asked to fast for a minimum of 12 hours before surgery.
  • You will be asked to arrange for a friend or relative to drive you home after the surgery is completed.

How Is Endoscopic Gastrointestinal Fistula Surgery Performed?

Endoscopic gastrointestinal fistula surgery is performed under general anesthesia. During the surgery, the fistula is cut open, the contents drained out and a repair is done to ensure the continuity and optimal functioning of the gastrointestinal tract. Here is what will happen to you during endoscopic gastrointestinal fistula surgery.

  • You will be given general anesthesia through an IV line fixed in a vein in your hand.
  • Depending on the location of your fistula, the endoscope will be inserted through your mouth or anus.
  • With the help of the camera on the endoscope, your surgeon will observe the images on the screen and locate the fistula.
  • Once the fistula is located, your surgeon will drain it and clean up the pus and blood that has flown out.
  • The fistula is then closed by one or a combination of the following:
    • A sealant
    • Sutures
    • Plugs and sponges that seal the openings and promote healing
    • Clips and stents, some of which stay in your body to seal the fistula opening and others that fall off gradually and get eliminated through stools.

Endoscopic Vacuum Assisted Closure (EVAC) is an emerging minimally invasive technique for fistula repair. 
Here, with the help of an endoscope, a negative vacuum is created to collapse the fistula and create a seal. The device used here consists of a sponge and tube attached to an external vacuum suction. This device ensures continuous suction that helps to remove all the secretions. It also promotes healing by forming granulation tissue.

What To Expect After An Endoscopic Gastrointestinal Fistula Surgery?

Recovery is the most crucial process in all fistula surgeries. Since this surgery is done endoscopically, you may expect faster recovery. It is an outpatient procedure, so you can expect to go home the same day. Endoscopic surgeries also guarantee low chances of infection post the surgery.

Once the surgery is complete, you will be shifted to a recovery room. Your vitals is your pulse rate, respiratory rate, temperature, and blood pressure, will be monitored. As you recover from the surgery, you may notice:

  • Pain as the effects of the anesthesia wear off
  • Nausea, vomiting, and dizziness due to the anesthesia
  • Cramping pains, bloating, and gases due to the air used to expand the surgical area

Once you are stable, you will be sent home with detailed instructions on postoperative care. Here is what you can do to recover faster from endoscopic gastrointestinal fistula surgery:

  • Avoid strenuous activities for 1-2 weeks after surgery. Take adequate rest. You may be able to get back to work the next day, but you will end up feeling exhausted very quickly. Hence it is advisable to take things slow.
  • Keep up your nutrition levels. Preferably eat bland food for a couple of weeks. Avoid spicy, oily, and salty food.
  • Stay hydrated by drinking adequate amounts of water
  • Avoid activities that strain the abdominal muscles, like pushing, pulling, and bending.

What Are The Benefits & Risks Of Endoscopic Gastrointestinal Fistula Surgery?

Every surgery has its pros and cons. Let us look at the benefits and risks of endoscopic gastrointestinal fistula surgery.

Benefits:

Fistulas chronic malnutrition and weight loss. They can get infected and lead to a dangerous condition called sepsis. Surgical treatment is extremely beneficial in dealing with a fistula. A surgical repair ensures that the fistula does not come back. A fistula surgery done by an experienced surgeon has a success rate of 90 to 97%, and the chances of recurrence are also very low.

Risks:

You may experience risks associated with general anesthesia such as:

  • Nausea
  • Vomiting
  • Dizziness

Risks specific to the procedure include:

  • Cramping pains, bloating, and gases due to the air used to expand the surgical area
  • Sore throat if you have had an upper GI endoscopic fistula surgery
  • Bowel obstruction if you have had a lower GI endoscopic fistula surgery.

Why Choose Medfin?

Surgery can be a daunting aspect, and feeling anxious is absolutely normal. The massive amount of information you can get from the internet may confuse you even more. This is where Medfin can help. Leave us the hefty task of finding the best hospital, the finest doctor, and the latest procedure at the lowest cost. Let us take charge while you sit back and focus on your health and recovery. Think surgery! Think Medfin!

The power of Medfin in patient’s words

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“ Got to know about them from my friend. They got an appointment for only 299. Once the doctor confirmed that I needed the surgery they got me a fixed cost which included ALL the costs. No extra amounts were charged. Thank you Medfin”

Suresh Menon Hyderabad 8 days ago
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“ After my consultation with the doctor, MEDFIN representative got me a fixed package cost that included my mothers initial tests, surgery cost. They also gave me stockings free for Rs. 3000 post the surgery. They kept up their promise they made”

Radhika Iyer Mumbai 8 days ago
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“ Thank you Medfin. They ensured the whole process from selecting a very experienced doctor to offering the latest procedure at a very reasonable price. They also arranged a follow up post my surgery with the doctor to ensure my recovery was on track. Thank you for being there throughout”

Deepa Shree Bangalore 8 days ago
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