Seton Placement
A surgical thread placed through the fistula tract - used for complex or high anal fistulas as a draining seton to control infection or a staged cutting seton to gradually address the sphincter safely.
What is Seton Placement?
A seton is a thread or suture material passed through the fistula tract and tied loosely (draining seton to control infection and allow inflammation to resolve before definitive repair) or progressively tightened (cutting seton). Draining setons keep the fistula open, manage discharge, and prepare the tract for a subsequent sphincter-preserving closure. Cutting setons slowly cut through the sphincter over weeks, allowing fibrous healing alongside.
Dr. Samhitha Reddy, a leading fistula specialist in Hyderabad, uses seton placement at Lux Hospitals as part of a staged treatment strategy for high trans-sphincteric and complex anal fistulas - particularly those associated with active infection or where a sphincter-preserving definitive procedure (LIFT, FiLaC) is planned for the second stage.
Seton placement is a staged or adjunct procedure - not a standalone curative treatment. The definitive procedure (LIFT, FiLaC, advancement flap) is planned after the seton phase. Dr. Samhitha will outline the complete staged plan at consultation.
How the Procedure Works
Assessment & Imaging
MRI pelvis and endoanal ultrasound characterise the fistula, identify secondary tracts, and confirm classification (high trans-sphincteric, suprasphincteric).
Anaesthesia & Tract Identification
Examination under anaesthesia (EUA) identifies internal and external openings. A fistula probe confirms the tract path and sphincter involvement.
Seton Insertion
A silicone sling, nylon suture, or similar material is threaded through the fistula tract and tied loosely (draining) or secured for graduated tightening (cutting seton).
Seton Management Phase
Patient reviewed every 4–6 weeks. The seton drains discharge, allows inflammation to settle, and prepares the tract for the definitive procedure.
Definitive Procedure
After 6–12 weeks, the definitive sphincter-preserving procedure (LIFT, FiLaC, advancement flap) is performed for complete fistula closure.
Outcomes
Who Needs This Treatment?
- →Controls infection and drainage while definitive repair is planned
- →Allows inflammation and induration to resolve before complex sphincter-preserving surgery
- →Staged approach reduces incontinence risk for high complex fistulas
- →Day-care procedure for seton insertion - no extended hospital stay
- →Preserves the full range of sphincter-preserving definitive options for the second stage
- →Well tolerated - most patients adapt quickly to the seton during the waiting phase
The seton is one of the most strategically important tools in managing complex fistulas. It buys time, controls infection, and gives us the best possible conditions for a successful sphincter-preserving closure in the second stage.
— Dr. Samhitha Reddy, Consultant Proctologist & Laparoscopic Surgeon, Lux Hospitals, Hyderabad
Seton Placement Cost in Hyderabad
The cost of seton placement in Hyderabad depends on the type of fistula, complexity of the tract, investigations required, and the care needed before and after the procedure.
For conditions such as high or complex anal fistula, where staged treatment with seton placement may be recommended, the approximate cost ranges from ₹25,000 to ₹55,000.
| Procedure | Approximate Cost Range |
|---|---|
| Seton Placement High / Complex, Staged Fistula | ₹25,000 – ₹55,000 |
The final cost may vary depending on your individual condition, fistula tract characteristics, findings during evaluation, and whether any additional procedures or post-operative care are required.
Factors That Influence Seton Placement Cost
The overall cost may depend on:
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Type and complexity of fistula: The location of the fistula tract, involvement of sphincter muscles, and whether the fistula requires staged management can influence the complexity of treatment.
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Pre-operative evaluation: Required investigations, clinical examination, imaging tests, and medical assessments before the procedure may affect the overall cost.
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Additional procedures: If procedures such as abscess drainage, fistula mapping, or further surgical treatment are required along with seton placement, the cost may vary.
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Hospital stay and post-operative care: The duration of admission, medicines, wound care, follow-up consultations, and monitoring during staged treatment may influence the final estimate.
Is Seton Placement Covered by Insurance?
Seton placement may be covered by health insurance when it is performed for a medically necessary condition. Coverage depends on your insurance policy, inclusions, waiting periods, and approval process.
Our insurance support team can assist you with checking your policy coverage, required documentation, cashless approval process, and insurance-related queries before the procedure.
- Checking your policy coverage
- Cashless approval process
- Required documentation
- Insurance-related queries before the procedure
Dr. Samhitha Reddy
Consultant Proctologist & Laparoscopic Surgeon
During consultation, Dr Samhitha Reddy, Proctologist and Colorectal Surgeon in Hyderabad, will evaluate your symptoms, fistula type, medical history, and examination findings to determine whether seton placement is suitable for you. She will explain the procedure, expected treatment plan, and guide you regarding the estimated cost based on your individual condition and treatment requirements.
Common Questions
Frequently Asked Questions
Not sure which treatment is right for you?
Book a consultation with Dr. Samhitha Reddy and get a personalised treatment plan.