Recorded at the International Conference of Anal Fistula Treatment in Rome 2018, Techniques in Coloproctology interview Phil Tozer, a consultant at the world famous St Mark's Hospital, UK about current treatments for anal fistula. Phil takes us through why not to place a seton in the acute setting, the 5 factors preventing healing of fistulas, and the pros and cons of the whole range of fistula treatment including plugs, fibrin glue, permacol, LIFT, the place of sphincter repair, restoring the contour of the anus, VAAFT (including "palliative VAAFT and delta VAAFT"), FiLAC and finally the promise of stem cells in fistula. Essential listening for anyone who treats anal fistula.