✦ SPHINCTER-PRESERVING FISTULA TREATMENT

Seton Placement

Q: How long do I need to keep the seton?

Loose drainage setons may be kept for several weeks to months until the tract calms down. Cutting setons are tightened periodically and may stay for a few months. The exact duration is individualised.

Q: Is the seton painful?

Most patients tolerate setons very well. Mild fullness or discharge is normal and managed with sitz baths and dressings. Severe pain is uncommon.

Q: Will the seton cure my fistula?

A seton is often a step in a staged plan rather than the final cure. After the tract has matured and infection is controlled, definitive sphincter-sparing surgery (LIFT, advancement flap, or laser closure) is planned.

Q: Can I lead a normal life with a seton?

Yes. Most patients work, exercise, and travel normally with a seton in place. Daily sitz baths, light dressings, and good hygiene help with comfort throughout this phase.

A soft, flexible thread (seton) placed through the fistula tract — used for complex or high fistulas to gradually heal the tract while preserving the sphincter muscle.

30–45 min PROCEDURE

Day Care HOSPITAL STAY

>85% SUCCESS RATE

2–3 Days RETURN TO WORK

What is Seton Placement?

Seton Placement is a sphincter-preserving surgical technique for complex anal fistulas, particularly high transsphincteric, suprasphincteric, or recurrent fistulas. A soft, flexible thread (seton) is passed through the fistula tract and tied loosely. The seton can act as a drain (loose seton — to keep the tract draining and prevent abscesses) or as a cutting seton (slowly tightened to gradually divide the muscle while allowing healing behind it). It is also commonly used as a staged approach before definitive sphincter-sparing surgery. As a female proctologist in Hyderabad, Dr. Tejasree Vengala performs seton placement at Lux Hospitals, Hyderabad.

Suitable for complex, high or recurrent anal fistulas, fistulas in patients with Crohn's disease, those at high risk of incontinence with simple fistulotomy, or as a staged approach before LIFT, advancement flap, or laser closure.

How the Procedure Works

Anaesthesia & Positioning

Surgery is performed under spinal or general anaesthesia. The patient is positioned in lithotomy or prone position.

Examination Under Anaesthesia

The internal and external openings of the fistula are clearly identified, and the entire tract is mapped.

Tract Probing

A fine probe is gently passed through the tract from external to internal opening to confirm the course.

Seton Threading

A soft seton (silicone vessel loop or similar) is threaded along the probe through the tract and tied loosely outside.

Discharge & Follow-Up Plan

Patients return home the same day with structured wound care advice and a clear follow-up plan for definitive surgery.

Outcomes

30–45 minDURATION

Day CareHOSPITAL STAY

>85%SUCCESS RATE

VariableDEFINITIVE SURGERY

Who Needs This Treatment?

→Preserves the anal sphincter muscle and continence
→Controls infection and prevents recurrent abscesses
→Effective for complex and high fistulas
→Useful in Crohn's disease-associated fistulas
→Allows safe staged definitive surgery later
→Discreet, sensitive care by a female proctologist

A loose seton is one of the kindest things we can offer in complex fistula disease — it controls infection, calms inflammation, and protects the sphincter while we plan the definitive operation thoughtfully. Sometimes the most important step is the one that comes before the cure.

— — Dr. Tejasree Vengala, Consultant Proctologist & Laparoscopic Surgeon, Lux Hospitals, Hyderabad

Common Questions

Frequently Asked Questions

How long do I need to keep the seton?+

Is the seton painful?+

Will the seton cure my fistula?+

Can I lead a normal life with a seton?+

Not sure which treatment is right for you?

Book a consultation with Dr. Tejasree Vengala and get a personalised treatment plan.

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