Nigam’s modified Roeder’s knot with cutting seton has advantages over hybrid cutting seton in high and complex fistula-in-ano

Background: Cutting seton is usually used in high or complex fistula-in-ano. Cutting seton with Nigam’s Modified Roeder’s Knot avoids rethreading and re-application of the cutting seton when becomes loose as the tightening is done in OPD during dressing without any pain or discomfort. While hybrid cutting seton of rubber or latex does not give the advantages of cutting seton with NMRK. Methods: Cutting seton with NMRK is an easy method of seton application in high and complicated cases of fistula-in-ano. It avoids recurrence as well as anal incontinence which is common after surgery for high and complex fistula-in-ano. Results: Cutting seton with NMRK is devoid of any post-operative serious complications. Recurrence and anal incontinence rate are minimal. Conclusions: Cutting seton with NMRK is proved to be better with application of hybrid seton in cases of high and complex fistula-in-ano.