Minimal Invasive Kshara Sutra Technique (MIKST)- A New Sphincter Sparing Technique for the Management of Trans-sphincteric Fistula in Ano Wsr Ushtragriva Bhagandara

Abstract

Acharya Sushruta mentioned the Bhagandara in Astha-Mahagada, due to difficult to treat this condition. Fistula in ano management is a growing burden to the surgeon’s society due to its recurrence chances. Overall prevalence rate of the fistula in ano is 8.6 per one lac. In present time there are many new advance techniques available for the management of fistula in ano in contemporary science but no any single technique is gold standard for this condition. So, it is a high time to amalgamate the ancient wisdom with new modern surgical techniques to overcome this condition. Methods: This study was conducted from May 2023 to 2025 at NIA, Jaipur and total 40 diagnosed patients of low trans-sphincteric fistula in ano selected and underwent MIKST. All the patients screened with all routine investigation prior to the surgery and written informed consent was taken. Preoperative, intra-operative and post-operative data collected and assess the clinical outcomes on different parameters for 6 weeks trial period and 6 weeks additional follow up and results were analyzed with Friedman statical test. Results & conclusion: The MIKST techniques showed the significant results in reducing pain, discharge from wound and post operative inflammatory signs and minimize the wound healing period, post operative complication, length of hospital stays and chance of recurrence. Therefore; MIKST can be considered as minimal invasive efficient technique for the low trans-sphincteric fistula in ano treatment.