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Classically, fistula surgery involves removal of the entire fistula tract. This procedure is called fistulectomy. Today, this is usually only done for small or short fistulas. For very short straight fistulas, fistulotomy can be an option. This involves cutting on the tract and laying it open to drain the pus, and then scraping out the fistula lining. This leaves a raw open wound that requires regular dressings till it heals in 4-8 weeks. A variety of plugging devise like setons and plugs have also been used. Setons are either cumbersome and uncomfortable to manage postoperatively. Both these are associated with higher recurrence rates, making them less popular choices. LASER and VAAFT (video-assisted anal fistula treatment) are popular newer techniques which can be used alone or in combination for most anal fistulas.

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