NICE has been notified about this procedure and it is part of its work programme. The Interventional Procedures Advisory Committee (IPAC) will consider this procedure and NICE will issue an interventional procedures consultation document about its safety and efficacy for 4 weeks’ public consultation. IPAC will then review the consultation document in the light of comments received and produce a final interventional procedures document, which will be considered by NICE before guidance is issued to the NHS in England, Wales, Scotland and Northern Ireland.
Status In progress
Process IP
ID number 1709
Description Radially emitting laser fibre treatment of an anal fistula can be done with the patient under regional or general anaesthesia. With the patient in lithotomy position, the external and internal openings of the fistula tract are identified. The fistula is then catheterised using a probe and cleaned by irrigation. Under ultrasound guidance, a radially emitting laser fibre is advanced from the external to internal orifice, activated and gradually withdrawn at about 1 mm/second. The aim is to cause destruction and sealing of the fistula tract, allowing primary closure. The procedure may be used with techniques that close the internal orifice of the tract such as an advancement flap.

Provisional Schedule

Expected publication 13 March 2019


Key events during the development of the guidance:

Date Update
03 December 2018 - 31 December 2018 Interventional procedure consultation

For further information on how we develop guidance, please see our page about NICE interventional procedures guidance