VAAFT for treating anal fistulae

The technology described in this briefing is VAAFT, or video-assisted anal fistulae treatment. It is a surgical kit used for treating anal fistulae.

The innovative aspects are that VAAFT includes a video camera which allows the surgeon to see inside the anal fistula tract, and an endoscope light to help with locating the internal opening of the tract.

The intended place in therapy would be as an alternative to other surgical techniques used to treat anal fistulae.

The key points from the evidence summarised in this briefing are from 4 uncontrolled open-label studies including 838 patients. These studies suggest that VAAFT is safe and well tolerated.

Key uncertainties around the evidence base, which is still developing, are that long-term healing and recurrence rates are unknown. VAAFT can be used to treat both simple and complex fistulae but it is currently unclear which subgroup would benefit the most.

The cost of VAAFT is £7,988 per unit for the reusable surgical kit, plus around £20 in single-use consumables per procedure (exclusive of VAT). There is insufficient information to judge the overall resource impact of VAAFT compared with NHS standard care. Fistulotomy is the most common treatment for anal fistula and costs £1,169 per procedure.