A Review of Surgical Approach taken by AcharyaSushrutain theManagement ofShataponakaBhagandaraw.s.r to MultipleTractFistulaIn Ano

Fistula in Ano is a track lined by granulation tissue, which connects perianal skin superficially to anal canal, anorectum or rectum deeply. It usually occurs in a pre-existing anorectal abscess which burst spontaneously. Acharaya Sushruta included Bhagandara in Ashtamaharoga and discussed it in detail based on its prevalence and difficulty in treatment. Shatponaka Bhagandara is one of the five varieties of Bhagandara that Acharya Sushruta has mentioned. In an effort to reduce recurrence rates and increase success rate over the past many years, numerous authors have proposed innovative procedures. However, Fistula-in-Ano is still a challenging surgical condition. In order to manage this difficult condition and create new trends in our understanding of Fistula-in-Ano, it is necessary to rediscover the old wisdom of Acharya Sushruta. The objective of this study is to review and interpret the surgical approach taken by Acharya Sushruta in the management of Shatponaka Bhagandara in light of contemporary surgical literatures, which may hold the key for successful management of this disease.