Want to Know The Most Advanced, Quick and Effective Solution for Treating Fistula?
Ligation of Intersphincteric Fistula Tract (LIFT) in Navi Mumbai
- Dr Nitish Jhawar, with 23 years of experience
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What is a Fistula?
A fistula is a small tunnel between the anus and skin that can get infected and leak pus. Doctors operate because, without surgery, the infection and pus drainage can return. The LIFT surgery finds this tunnel, ties it off in the middle to stop any connection, and seals it so the area can heal.
Normally, the inside of your anus and the outside of your skin should be completely separate, but a fistula creates a hole between them. This tunnel often lets out pus, a thick, yellowish liquid, which can sometimes be smelly and uncomfortable. This happens because a fistula is often caused by an infection, and the pus is your body’s way of trying to fight off that infection.
Why Is Surgery For Fistula Needed?
If you don’t treat a fistula, it can cause ongoing problems:
- Repeated Infections: The area might get infected repeatedly, making it painful, swollen, and sometimes very red.
- Constant Pus Drainage: This can be uncomfortable, especially since the pus might keep leaking.
- Risk of Spreading Infections: If the infection spreads, it could even affect other parts of your body.
What Happens in the LIFT Surgery For Fistula?
LIFT stands for Ligation of the Intersphincteric Fistula Tract. Don’t worry about the long name—it just describes where and how doctors work to close up the tunnel.
- Finding the Tunnel: First, doctors find the tunnel. They use special tools to locate exactly where it starts and ends, both inside and outside.
- Blocking the Tunnel: Once they’ve found the tunnel, they go to the middle part (like finding the middle of a straw) and carefully tie it off. This stops the connection between the inside and outside.
- Closing It Up: They’ll close off the inside and outside openings of the tunnel so no more infection can get through, and the tissue can heal.
- Healing Time: After the surgery, the body starts to heal the area naturally, with no tunnel left for infection to return.
In simple terms, LIFT surgery seals up the fistula tunnel, preventing infections and helping the area return to normal.
How Does Dr. Nitish Perform LIFT Surgery For Fistula Removal in Navi Mumbai?
The LIFT (Ligation of Intersphincteric Fistula Tract) procedure is a specialized surgical technique designed to treat anal fistulas by safely closing the abnormal passage while preserving muscle function and minimizing post-surgery complications.
Here’s a clear breakdown of each step in the LIFT procedure, from pre-surgery preparation to post-operative care.
Step 1: Pre-Surgery Preparation
- Initial Consultation: The doctor will conduct an in-depth consultation to understand your medical history, examine the fistula, and assess your overall health.
- Diagnostic Tests: Imaging tests, such as an MRI, Fistulography, or ultrasound, may be conducted to determine the fistula’s location and extent.
- Preparation Instructions: You’ll receive guidelines on what to do before the procedure, like avoiding food or certain medications, usually 8 hours before surgery.
Step 2: Anaesthesia
- Administering Anaesthesia: The LIFT procedure is typically performed under general anaesthesia to ensure patient comfort and prevent pain during surgery.
- Positioning: Once the anaesthesia takes effect, you’ll be positioned for the procedure to allow easy access to the fistula area.
Step 3: Locating the Fistula Tract
- Identifying the Fistula Path: The surgeon carefully locates the fistula tract by making a small incision near the anus and separating the layers of tissue between the sphincter muscles.
- Accessing the Intersphincteric Space: This area lies between the internal and external anal sphincters, where the fistula tract is typically found.
Step 4: Ligation of the Fistula Tract
- Tying Off the Tract: Once the fistula tract is located, the surgeon ties it off (ligates) to block any connection between the anal canal and the skin surface.
- Severing the Tract: After the tract is tied off, it’s carefully severed to close the pathway and allow for healing. This step prevents pus from accumulating and minimizes the risk of infection returning.
Step 5: Closing the Incision
- Sealing the Area: The surgeon closes the internal and external openings and the incision area. This sealing allows the wound to heal properly, with no open connections remaining.
- Final Inspection: Before concluding, the surgeon inspects the area to ensure all steps are completed and the fistula has been properly closed.
Step 6: Post-Operative Care
- Recovery Room Observation: Following the surgery, you’ll be monitored in a recovery room until the effects of the anaesthesia wear off.
- Pain Management: The doctor will prescribe pain relievers to manage any discomfort and antibiotics to prevent infection.
- Home Care Instructions: You’ll receive guidelines for caring for the area, including:
- Hot-Sitz bath
- Keeping the area clean and dry.
- Avoiding strenuous activities for a few weeks.
- Following a fiber-rich diet to avoid constipation.
- Follow-Up Appointments: Regular follow-ups are scheduled to monitor healing progress and address any concerns.
Key Benefits of the LIFT Technique For Anal Fistula Surgery in Navi Mumbai
Minimal Pain
The LIFT technique is designed to avoid cutting through the sphincter muscles, which means less trauma to the surrounding tissue. As a result, patients experience significantly less pain during and after the procedure than other methods.
Low Risk of Complications
Because the LIFT technique spares the sphincter muscles, it carries a much lower risk of complications, especially those related to muscle damage. This means a greatly reduced chance of incontinence (loss of control over bowel movements), which is a primary concern in fistula surgeries.
Faster Recovery
Patients undergoing LIFT typically have a shorter recovery period, often returning to regular activities in just a few weeks. Since it’s a muscle-sparing technique, the body can heal more quickly without prolonged downtime.
High Success Rates
Studies have shown that the LIFT procedure has high success rates, especially for complex and deep fistulas. By closing off the fistula tract effectively, LIFT reduces the risk of fistula recurrence, providing long-term relief for most patients.
How Does LIFT Compare to Other Treatments For Fistula?
When it comes to treating anal fistulas, there are several surgical options, each with its own advantages and disadvantages. Here’s how LIFT compares to other common treatments:
Fistulotomy
In a fistulotomy, the surgeon opens up the entire length of the fistula tract to allow it to heal from the inside out. While effective, fistulotomy often involves cutting through some of the sphincter muscles, which can increase the risk of incontinence and require a longer healing period. LIFT is advantageous because it avoids muscle cuts, reducing these risks.
Seton Placement
Seton placement involves inserting a special thread through the fistula tract to help drain infection and encourage healing. While setons are often used for complex or high fistulas, they require multiple follow-up visits and may remain in place for several months, which can be uncomfortable for patients. On the other hand, the LIFT procedure offers a one-time solution with a quicker path to healing.
Who is an Ideal Candidate for the LIFT Technique?
- Patients with Complex or High Fistulas: This procedure is suitable for deep or high fistulas that pass through significant muscle. It allows closure without cutting the muscle, thus reducing complications.
- Those Concerned About Incontinence Risks: This procedure is ideal for patients with weakened sphincter muscles, such as the elderly or those with previous surgeries, as it preserves muscle control.
- Patients Seeking Minimally Invasive Options: Offers a muscle-sparing approach with less discomfort, faster recovery, and minimal pain.
- Individuals with Recurring Fistulas: Reliable for recurring fistulas, especially when other treatments have failed, reducing long-term recurrence.
When LIFT May Not Be Suitable For Treating Fistula?
- Active Infection or Abscesses: Requires infection control first; drainage or antibiotics may be recommended before LIFT.
- Simple, Low Fistulas: Low-lying, simple fistulas may be better treated with a more direct procedure like fistulotomy.
- Patients with Crohn’s Disease: Inflammation may slow healing; seton placement or medications are often preferred.
- Multiple Fistulas: LIFT may not address multiple tracts effectively; other or combined methods may be recommended.
Risks and Considerations of the LIFT Technique For Fistula Removal
Potential Risks
- Infection: There is a possibility of infection at the surgical site; symptoms include redness, swelling, and pus.
- Fistula Recurrence: The fistula may reopen, requiring further treatment.
- Bleeding: Some bleeding is normal, but excessive bleeding is a concern.
- Pain: Mild discomfort is expected, but severe pain could indicate complications.
- Delayed Healing: Healing may be slower, especially in patients with diabetes or Crohn’s disease.
Precautions
- Professional Assessment: It is essential to evaluate individual needs before choosing LIFT.
- Post-Surgery Care: Keep the area clean, avoid strain, and follow care instructions closely.
- Regular Follow-Ups: Attend follow-up appointments to monitor healing.
- Health Factors: Chronic conditions may require extra care and should be discussed with a doctor.
Recovery and Aftercare for the LIFT Technique
Typical Recovery Timeline
- First Few Days: Mild pain and swelling; patients may resume light activities.
- 1-2 Weeks: Most discomfort subsides; avoid strenuous activities, heavy lifting, and sitting for long periods.
- 3-4 Weeks: Healing completes for most patients, and they can resume regular activities gradually.
Aftercare Tips
- Keep Area Clean: Gently wash the area with mild soap, and pat dry after bowel movements.
- Pain Relief: Take prescribed pain medications as directed.
- Dietary Adjustments: Increase fiber and fluids to prevent constipation.
- When to Seek Medical Advice: Contact your doctor if you notice unusual pain, fever, excessive bleeding, or signs of infection.
Following these guidelines can help support healing and reduce the risk of complications.
Frequently Asked Questions (FAQs) about the LIFT Technique
The LIFT procedure typically takes 30-60 minutes. It’s a relatively quick surgery, often completed in less than an hour under general anaesthesia.
The LIFT technique has a success rate of 70-90%, especially for complex and high fistulas. Success rates may vary based on the fistula’s location and individual patient health.
Most patients experience mild to moderate discomfort rather than severe pain. Since the LIFT procedure avoids cutting through muscle tissue, pain is less intense than other fistula treatments.
Many patients can resume light activities within a few days and normal activities in 2-4 weeks. However, strenuous exercise and heavy lifting should be avoided for at least a month to ensure proper healing.