Surgical treatment of trans-sphincteric anal fistulas with the Fat GRAFT technique: a minimally invasive procedure

Aim Anal fistulas are common pathologies with a significant social impact; however their treatment is often complex and the recurrence rate can be significant. Some surgical treatments for fistula are also associated with the risk of sphincter injury. In this technical note, we aim to evaluate the feasibility and efficacy of the Fat GRAFT technique (Fat Grafting in Anal Fistula Treatment) in the treatment of recurrent anal fistulas. Method All patients presenting with recurrent trans-sphincteric anal fistulas over an 18-month period were included. After abdominal fat harvesting and fat preparation, fat grafting was performed in the track and peripheral area of the fistula. The internal and external openings of the fistula were closed to maximally preserve the retention of the adipocyte graft in the fistula. Results Eleven patients underwent the Fat GRAFT procedure (7 men, 4 women). The average re-injected volume for each fistula was 21 cc (range, 10–30 cc). The postoperative course was uneventful. At 6 months 3 patients developed recurrence (73% healed). There were no post-operative complications. . Conclusion The Fat GRAFT technique appears to be a promising technique with a low risk of anal incontinence, in contrast to other techniques. This method was effective in >70% of patients in a single session. This article is protected by copyright. All rights reserved.