LIFT technique

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Surgical technique for treating anal fistulas


The LIFT technique (Ligation of Intersphincteric Fistula Tract) is a surgical procedure used to treat anal fistulas. This technique is designed to close the fistula tract and preserve the anal sphincter muscles, thereby minimizing the risk of fecal incontinence.

Procedure[edit | edit source]

The LIFT technique involves several key steps, which are performed under anesthesia. The procedure is typically done on an outpatient basis.

Identification of the Fistula Tract[edit | edit source]

The first step in the LIFT procedure is to identify the fistula tract. This is done by probing the external opening of the fistula to locate the tract.

Identifying the internal opening of the fistula

Incision at the Intersphincteric Groove[edit | edit source]

Once the tract is identified, an incision is made at the intersphincteric groove. This allows access to the fistula tract between the internal and external sphincter muscles.

Incision at the intersphincteric groove

Dissection and Ligation of the Tract[edit | edit source]

The fistula tract is then carefully dissected and isolated. The tract is ligated at the level of the intersphincteric space to prevent the passage of fecal material through the tract.

Identifying the intersphincteric tract

Suturing the Tract[edit | edit source]

After ligation, the tract is sutured to ensure it is securely closed. This step is crucial to prevent recurrence of the fistula.

Suturing the fistula tract

Curettage of the External Opening[edit | edit source]

The external opening of the fistula is curetted to remove any granulation tissue and to promote healing.

Curettage from the external opening

Closure of the External Sphincter[edit | edit source]

Finally, the external sphincter is closed, completing the procedure.

Closure of the external sphincter

Advantages[edit | edit source]

The LIFT technique offers several advantages over traditional fistula surgery methods:

  • Sphincter Preservation: By avoiding division of the sphincter muscles, the risk of incontinence is significantly reduced.
  • High Success Rate: The procedure has a high success rate in terms of fistula healing and low recurrence rates.
  • Minimal Postoperative Pain: Patients typically experience less pain compared to other surgical techniques.

Complications[edit | edit source]

While the LIFT technique is generally safe, potential complications include:

  • Infection
  • Recurrence of the fistula
  • Bleeding
  • Temporary incontinence

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Contributors: Prab R. Tumpati, MD