LIFT procedure: a simplified technique for fistula-in-ano

Abstract

The novel modified approach through the intersphincteric plane for the treatment of fistula-in-ano, known as LIFT (ligation of inter sphincteric fistula tract) procedure, is described in detail. LIFT procedure is based on secure closure of the internal opening and removal of infected cryptoglandular tissue through the intersphincteric approach. Essential steps of the procedure include, incision at the intersphincteric groove, identification of the intersphincteric tract, ligation of intersphincteric tract close to the internal opening and removal of intersphincteric tract, scraping out all granulation tissue in the rest of the fistulous tract, and suturing of the defect at the external sphincter muscle. Attention to detail is the key for a favorable outcome.

Ligation of the intersphincteric fistula tract (LIFT) to treat anal fistula: early results from a prospective observational study

“…Reported recurrence and incontinence rates range from 0 to 32% and from 0 to 63%, respectively [1,2]. These wide ranges depend on many factors, but the surgical technique is the major one.…”

Lift Technique for Fistula in ANO with Redefined Criteria – A Step towards Better Outcome.

“…[1]. Recurrence rate of lay open of fistulotomy is around 2-9%, with functional impairment of from 0-17% [1].Seton use has a recurrence rate of 0-8%.Incontinence rates of 2-26%.Endorectal advancement flap has healing rate of 98% with minor & major incontinence of 31 & 12%.Direct closure of internal opening has a 22.5% recurrence rate & 6% minor incontinence [1].…”

“…Fistula in ano does not heal spontaneously due to fecal particles entering internal opening causing infection & the intersphincteric tract is compressed between the internal & external sphincter causing a closed septic foci [1]. Surgical techniques used are -Lay-open of fistula-in-ano, cutting seton, seton stitch, fibrin glue injection, fistula plug, endorectal advancement flap, vaaft etc.…”

“…Surgical techniques used are -Lay-open of fistula-in-ano, cutting seton, seton stitch, fibrin glue injection, fistula plug, endorectal advancement flap, vaaft etc. [1].…”

“…Anal fistula is an abnormal connection between the epithelialized surface of anal canal and (usually) the perianal skin [1]. Fistula in ano does not heal spontaneously due to fecal particles entering internal opening causing infection & the intersphincteric tract is compressed between the internal & external sphincter causing a closed septic foci [1].…”