Bhagandara (Fistula-in-ano) is one among the most common gudagata vikara. Bhagandara is considered as Ashtamahagada by Acharya Sushruta. It starts as a deep rooted pidaka around the guda within 2 angulas and later forms a tract with an external opening in the skin of perianal region connecting an internal opening in the skin or mucosa of anal canal or rectum lined by unhealthy granulation tissue and fibrous tissue. The main clinical features include pain, swelling around anus and pus discharge. In modern world, the medical science is so advanced in all aspects of treatments and surgical procedures but still the treatment for the Fistula-in-ano is not yielding satisfactory results because of its repeated recurrence rate. Acharya Sushruta has mentioned Chedana karma as main line of treatment in the management of Bhagandhara. It is the important surgical procedure explained among Ashtavidha Shastrakarma. Acharya Sushrutha mentioned different types of incisions for Chedanakarma like Langalaka, Ardhalangalaka, Sarvathobhadraka, Gothirthaka incase of Vataja Bhagandhara and Kharjura patraka, Chandrardha, Chandrachakra, Suchimukha and Avangamukha for the Kaphaja Bhagandhara. All these chedana procedures are explained for the proper excision of the fistulous track. The incisions are planned in the manner that it explores the maximum cavity of fistula including secondary track also. So, these incisions are fully valid in the modern-day surgery.
Bhagandhara, Chedanakarma, Ashtamahagada, Fistula-in-ano
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