Dealing with an anal fistula can be a distressing experience for many patients. Beyond the physical discomfort and discharge, a key concern is the risk of faecal incontinence associated with traditional “cutting” surgeries.
Fortunately, medical advancements have introduced VAAFT (Video-Assisted Anal Fistula Treatment), a minimally invasive technique designed to preserve the anal sphincter muscles while addressing the internal opening of the fistula.
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What is VAAFT?
VAAFT is a minimally invasive surgical procedure used to treat anal fistulas, particularly complex cases. Unlike conventional methods that may involve cutting through sphincter muscle, VAAFT uses a specialised endoscope (fistuloscope), allowing the surgeon to directly visualise the fistula tract.
The procedure generally involves two phases:
Diagnostic Phase:
The surgeon inserts the fistuloscope through the external opening to map the tract and identify the internal opening under direct vision.
Operative Phase:
Once identified, the tract is cleaned (ablated or cauterised) from within, and the internal opening is closed using sutures or other closure techniques.
Why Patients in Singapore May Consider VAAFT
In Singapore’s fast-paced environment, many patients prefer treatments that allow quicker recovery and minimal disruption. VAAFT offers several potential advantages:
- Sphincter Preservation: The procedure avoids cutting the sphincter muscles, reducing the risk of bowel incontinence.
- Minimal Wounds: There are no large open wounds, which reduces the need for extensive wound care compared to procedures like fistulotomy.
- Direct Visualisation: The camera allows identification of secondary tracts that may otherwise be missed.
- Faster Recovery: Many patients resume normal activities earlier than with conventional surgery.
Understanding the Cost of VAAFT in Singapore
Financial planning is an important consideration for patients in Singapore.
Based on publicly available sources such as Ministry of Health (MOH) fee benchmarks, the typical bill size for anal fistula surgery performed as a day surgery in private hospitals generally ranges from approximately $6,800 to $14,000 or more.
As VAAFT is a specialised minimally invasive technique, actual costs may vary and can be higher depending on several factors, including:
- Complexity of the fistula
- Duration of surgery and hospital stay
- Surgeon’s fees and experience
- Type of anaesthesia used
Singapore Citizens and Permanent Residents may use MediSave, subject to withdrawal limits. Those with Integrated Shield Plans (IPs) may have a significant portion of costs covered, depending on their policy and panel arrangements.
Specialists You May Consider
Choosing a surgeon experienced in colorectal or proctological conditions and minimally invasive techniques is important for optimal outcomes.
Dr Chong Choon Seng 张峻诚医生
[SG] Featured Doctor
Featured Story
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Frequently Asked Questions (FAQs)
1. Is VAAFT a permanent cure for anal fistulas?
While VAAFT has shown favourable success rates, no procedure can guarantee zero recurrence. Outcomes depend on factors such as fistula complexity and patient healing.
2. How long is the recovery period after the procedure?
Many patients can return to sedentary work within a few days. Full healing of the tract may take several weeks.
3. Can I use my MediSave for VAAFT?
Yes, VAAFT is a recognised surgical procedure, and MediSave may be used within MOH limits. Integrated Shield Plans may further reduce out-of-pocket costs.
4. Will I experience pain during or after the surgery?
The procedure is performed under general or regional anaesthesia. Post-operative discomfort is usually mild to moderate and manageable with medication.
5. How do I know if I am suitable for VAAFT instead of a fistulotomy?
VAAFT is often considered for complex or high fistulas involving a significant portion of the sphincter. A specialist assessment—sometimes including MRI or endoanal ultrasound—will determine suitability.