SURGICAL TREATMENT FOR PERIANAL FISTULA: DEMONSTRATION OF THE LIFT TECHNIQUE

Introduction/Case Presentation A 61-year-old female, previously healthy, presented with a perianal abscess of cryptoglandular origin 9 years ago, which was surgically drained in an urgent setting. She was subsequently referred to a proctologist due to complaints of intermittent discharge of fecaloid material from the perianal region. During follow-up, a proctological examination identified an external opening of a perianal fistula located antero-laterally to the left, 1.5 cm from the anal margin, with fecaloid discharge and no signs of inflammation or infection. The patient had no complaints of anal incontinence, and the fistula diagnosis was confirmed by pelvic MRI, classified as PARKS I and Grade I according to the St James radiological classification. During the intraoperative examination under anesthesia, the fistula was reclassified as PARKS II, leading to the decision to perform surgical management of the perianal fistula using the LIFT (Ligation of Intersphincteric Fistula Tract) technique.

Objective The objective of the video is to demonstrate the LIFT technique (ligation of the intersphincteric fistula tract), illustrating the step-by-step process of the method, from patient positioning and surgical strategy to postoperative results.

Final Comments/Conclusion The patient was discharged on the first postoperative day and continues to follow up without signs of changes in anal continence or recurrence of the fistula. The LIFT technique demonstrated in the video was initially described by Rojanasakul in 2007 and is preferably indicated for transsphincteric and rectilinear intersphincteric fistulas. Currently, it should be part of the armamentarium of techniques for the surgical management of anorectal fistulas for colorectal surgeons.

No conflict of interest has been declared by the author(s).

Publication History

Article published online:
25 April 2025