The use of seton still remains a reasonably valid option for its simplicity and optimal results in treating high anal fistulae. Ours was a single-centre retrospective study on patients with supra-sphincteric and transsphincteric types of high anal fistula, using the ‘kharsutra’ as seton. The first group were treated with a seton alone, while the second with a seton and partial fistulotomy. Results were similar and quite acceptable in both groups.

Surgical innovations have a long tradition and are fundamental to the future of surgery. Practical application of an idea is its essence. It is the surgeon’s responsibility to discover, translate and propagate such ideas to reduce surgical costs for the economically downtrodden. Our article addresses one aspect of this.