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Ligation of the intersphincteric fistula tract (LIFT)

LIFT is a total anal sphincter-saving technique for the treatment of fistula-in-ano. It is a novel surgical technique based on the secure closure of the internal opening and removal of infected tissue through the intersphincteric approach. The procedure allows the surgeon to access the fistula between the sphincter muscles and avoid cutting them.
Indication for LIFT
Complex or deep fistulas
The procedure starts by surgeon making an incision in the opening of the fistula to determine its intersphincteric tract. The surgeon then makes another opening through the external opening of the fistula on the buttocks, to insert a tube to identify the tract and clean the area. Now infected tissue is removed and openings are sealed to prevent further infection and re-occurrence of a fistula.
This procedure can also be performed in two-parts:
Firstly a seton is placed into the fistula tract to widen it over time.
After several weeks, the surgeon removes infected tissue and closes the internal fistula opening. This leads to isolation of the mid portion of the fistula. This is now stitched closed, allowing the internal and external openings to collapse and heal.
Advantages of LIFT
Safe and easy to perform
Preservation of the anal sphincter
Minimal tissue injury
Shorter healing time