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Conditions/Anal Fistula/Chapter

Detailed chapter

Anal Fistula — Laser Fistula Treatment (FiLaC)

Sphincter-sparing laser ablation

FiLaC passes a thin laser fiber through the fistula tract to ablate the lining from inside, aiming to close the channel without cutting the sphincter. It suits selected anatomy in experienced centers. Short-term results are reasonable in many series; long-term healing data are more limited than for classic techniques.

FiLaC · educational illustration · English labels below

Who may be a candidate?

  • Selected transsphincteric tracts
  • Continence preservation priority
  • No active large abscess cavity
  • Often after seton preparation

Key points

  • Expectation management
    Tap for details · key note inside

    Not a one-needle cure. Success varies; recurrence may need LIFT, flap, or another sphincter-sparing option.

  • Possible advantages
    Tap for details

    No sphincter division, smaller wound, faster return to routine in many patients.

  • Limitations
    Tap for details

    Active sepsis, horseshoe branches, or very wide tracts may need drainage/seton first.

  • FiLaC vs VAAFT
    Tap for details

    VAAFT uses video to debride the tract; FiLaC uses laser energy to obliterate the channel—they are different tools.

This page is for education. It is not medical advice and does not replace a visit with your physician.

Medical editor: Assoc. Prof. Cengiz Dibekoğlu, MD · Last medically reviewed: August 2026 · English patient-education chapter.