Bhagandara (Fistula in ano) is a troublesome surgical disease. Several techniques have been described from ancient age to till date for the management of fistula-in-ano, but every technique has its own limitations. These techniques also carry their own risks of recurrence and incontinence. Conventional fistula surgery techniques have their place, but new technologies such as Ano-rectal Advancement flap Repair, Dermal Island Flap Anoplasty, Fibrin Glue, Fistula Plug, LIFT Procedure, BioLIFT Procedure, Adipose-Derived Stem Cells, VAAFT, PERFACT and OTSC Fistula Closure provide promising alternatives to traditional methods of management, with very good success rates. This review summarizes the revolution in the management of fistula in ano, from ancient to modern age with the recent techniques available currently.
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