Research & Publications

JCIMCR

Journal of Complementary & Integrative Medicine Case Reports — published case study from Kaalimadom Ayurveda Hospital.

Published in JCIMCR
Case Report

DL-KAST (Distal Laser, followed by Kshara Application Internally and Seton Drainage) — A New Hybrid Technique for Fistula in Ano

Bhagandara Fistula in Ano Ksharasutra Hybrid Technique DL-KAST

Published in the Journal of Complementary & Integrative Medicine Case Reports (JCIMCR).
This case report presents DL-KAST — an innovative hybrid approach developed at Kaalimadom Ayurveda Hospital that combines modern laser technology with classical Ayurvedic Ksharasutra therapy and seton drainage for effective management of anal fistula.

DL-KAST

Distal Laser-followed by Kshara Application Internally and Seton Trainage

D
Distal Laser
Laser energy is applied to the distal portion of the fistulous tract to destroy the epithelial lining and promote closure.
K
Kshara Application Internally
Medicated Kshara (Ayurvedic alkaline paste) is applied internally to the tract — the classical Ksharasutra action that promotes chemical debridement and healing.
S
Seton Drainage
A seton thread is placed through the proximal segment to maintain drainage, prevent abscess formation, and progressively cut through tissue while preserving the sphincter.

Why DL-KAST?

Fistula in ano (Bhagandara in Ayurveda) is a notoriously challenging anorectal condition. Conventional surgical methods carry a significant risk of fecal incontinence due to sphincter damage, while Ksharasutra alone may be slow in complex fistulae.

DL-KAST addresses this by using laser energy on the easier-to-access distal tract, reserving the gentle, tissue-preserving Ksharasutra action for the internal segment closest to the sphincter — and placing a seton to manage any remaining proximal extension.

This combination minimises sphincter trauma, optimises healing time, and delivers a more comprehensive outcome than any single modality used alone — making it a meaningful advancement in Ayurvedic anorectal surgery.

Keywords
Bhagandara Fistula in Ano DL-KAST Distal Laser Kshara Application Seton Drainage Ksharasutra Hybrid Technique Ayurvedic Case Report JCIMCR

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