Seton Placement
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.
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.
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
Who Needs This Treatment?
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Preserves the anal sphincter muscle and continence
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Controls infection and prevents recurrent abscesses
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Effective for complex and high fistulas
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Useful in Crohn's disease-associated fistulas
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Allows safe staged definitive surgery later
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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
Not sure which treatment is right for you?
Book a consultation with Dr. Tejasree Vengala and get a personalised treatment plan.