LIFT Procedure
What is the LIFT Procedure?
The Ligation of Intersphincteric Fistula Tract (LIFT) procedure is a surgical technique used to treat anal fistulas, particularly complex or transsphincteric fistulas, by ligating and dividing the fistula tract in the intersphincteric space while preserving sphincter function. It is a sphincter-sparing alternative to traditional fistulotomy, minimizing the risk of incontinence. In India, the LIFT procedure is performed in specialized colorectal surgery centers, offering effective, affordable care. For patients and families in India, understanding the procedure, costs, recovery, risks, and frequently asked questions (FAQs) is essential for informed decision-making and optimal outcomes.
Why do you need LIFT Procedure?
Anal fistulas are abnormal connections between the anal canal or rectum and the perianal skin, often resulting from infected anal glands. The LIFT procedure is indicated for:
- Complex anal fistulas: Transsphincteric fistulas involving significant sphincter muscle, where fistulotomy risks incontinence.
- Recurrent fistulas: After failed previous surgeries (e.g., fistulotomy, seton placement).
- Fistulas with single tracts: Best suited for fistulas with a clear, unbranched path.
- Patients seeking sphincter preservation: Particularly those with Crohn’s disease or women with anterior fistulas (higher incontinence risk).
The LIFT procedure aims to eliminate the fistula tract, promote healing, and maintain continence. In India, hospitals like Apollo, Fortis, Medanta, and Narayana Health specialize in LIFT, often combining it with other techniques for complex cases.
Why Do LIFT Procedure Costs Vary in India?
The cost of the LIFT procedure in India ranges from ₹40,000 to ₹1.5 lakh, depending on:
- Procedure Type:
- Standard LIFT: ₹40,000–₹90,000
- Modified LIFT (e.g., with fistulectomy or flap): ₹80,000–₹1.5 lakh
- Advanced imaging (e.g., MRI) or seton placement: Higher costs
- Hospital & Location: Top hospitals in metro cities (e.g., Apollo, Fortis) charge more; government hospitals (e.g., AIIMS) cost ₹15,000–₹50,000 but may have wait times.
- Specialist Expertise: Experienced colorectal surgeons charge higher fees.
- Extra Costs: Diagnostics (MRI, ultrasound, proctoscopy), anesthesia, medications, or complex fistulas requiring multiple procedures add to expenses.
- Insurance & Aid: Many insurance plans cover LIFT for symptomatic/complex fistulas; Ayushman Bharat offers free or subsidized treatment at empanelled hospitals.
LIFT Procedure
The LIFT procedure is a minimally invasive surgery, typically performed as a day-care or short-stay procedure:
- Before Procedure Evaluation:
- Diagnosis is confirmed via:
- Physical examination: Identifies the external opening, discharge, or abscess.
- Proctoscopy or sigmoidoscopy: Locates the internal opening in the anal canal.
- MRI or endoanal ultrasound: Maps the fistula tract, confirming its transsphincteric nature and ruling out branches or abscesses.
- Blood tests ensure surgical fitness, particularly for patients with comorbidities or Crohn’s disease.
- Bowel preparation (enemas or laxatives) reduces contamination during surgery.
- Patients are counseled on post-operative care, potential recurrence, and the low risk of incontinence.
- Diagnosis is confirmed via:
- Surgical Technique:
- Standard LIFT Procedure:
- Performed under general or spinal anesthesia, lasting 30–60 minutes.
- The patient is positioned in the lithotomy (legs raised) or prone position.
- A probe is inserted through the external opening to trace the fistula tract to the intersphincteric space (between the internal and external anal sphincters).
- A small incision (1–2 cm) is made over the intersphincteric groove (lateral to the anus).
- The fistula tract is isolated, ligated (tied off) on both sides (internal and external sphincter sides) with absorbable sutures, and divided to interrupt the connection.
- The internal and external openings may be curetted or left to heal naturally; the intersphincteric incision is closed or left open.
- Modified LIFT (LIFT-Plus):
- For complex or recurrent fistulas, additional steps like fistulectomy (excision of the external tract) or advancement flap (covering the internal opening) are combined to improve success rates.
- Adjuncts:
- In some cases, a seton (thread) is placed pre-LIFT to mature the tract or manage infection, removed during or after the procedure.
- The procedure is typically outpatient, with same-day discharge unless complications arise.
- Standard LIFT Procedure:
- After Procedure:
- Patients are monitored for a few hours to ensure recovery from anesthesia and pain control.
- Pain medications (e.g., paracetamol, ibuprofen) and stool softeners (e.g., lactulose) ease bowel movements and reduce strain.
- Sitz baths (warm water soaks) 2–3 times daily promote healing and hygiene.
- Follow-up visits assess wound healing, fistula closure, and continence.
Recovery After LIFT Procedure
Recovery is relatively quick but requires careful wound care to ensure fistula closure:
- Hospital Stay:
- Most patients are discharged the same day (outpatient) or within 24 hours.
- A 1–2 day stay may be needed for complex cases or pain management.
- Post-Procedure Care:
- Pain is moderate for 1–2 weeks, especially during bowel movements, managed with oral painkillers, sitz baths, and topical anesthetics (e.g., lignocaine).
- Stool softeners and high-fiber diets prevent constipation and reduce strain.
- The anal area must be kept clean and dry; patients are advised to shower after bowel movements or use wet wipes.
- Antibiotics may be prescribed short-term if infection risk is high (e.g., Crohn’s disease).
- Activity and Diet:
- Light activities (e.g., walking) resume within 1–2 days; strenuous activities (e.g., heavy lifting, sports) are avoided for 2–4 weeks.
- A high-fiber diet (fruits, vegetables, whole grains) and 2–3 liters of water daily promote soft stools.
- Avoid spicy foods, alcohol, or caffeine, which may irritate the bowels or worsen pain.
- Follow-Up:
- Follow-up visits at 1–2 weeks, 4–6 weeks, and 3 months assess wound healing, fistula closure, and continence.
- Healing typically occurs within 4–8 weeks, with symptom resolution by 2–4 weeks.
- Imaging (MRI or ultrasound) may be used to confirm fistula closure in recurrent cases.
Most patients resume normal activities within 1–3 weeks, with success rates of 70–90% for primary LIFT and 80–95% for LIFT-Plus. Recurrence rates are 10–30%, higher in complex fistulas or Crohn’s disease.
Risks and Complications
The LIFT procedure is low-risk and sphincter-sparing but carries potential complications:
- Surgical Risks:
- Bleeding, usually minor but rarely requiring intervention.
- Infection at the intersphincteric incision or fistula site, treated with antibiotics or drainage.
- Fistula-Related Risks:
- Fistula recurrence (10–30%), requiring repeat LIFT, fistulotomy, or other procedures.
- Incomplete ligation, leading to persistent fistula or abscess formation.
- Sphincter-Related Risks:
- Fecal incontinence (1–5%), typically minor (e.g., gas leakage), and much lower than fistulotomy (10–30%).
- Temporary anal discomfort or altered sensation.
- General Risks:
- Adverse reactions to anesthesia.
- Delayed wound healing, particularly in patients with Crohn’s disease or diabetes.
- Long-Term Issues:
- New fistula formation (rare), especially in complex or branched tracts.
- Chronic pain, uncommon with proper technique.
Prompt reporting of symptoms like persistent discharge, fever, or incontinence ensures timely management.
Frequently Asked Questions (FAQs)
What causes anal fistulas requiring the LIFT procedure?
Fistulas often result from infected anal glands, leading to abscesses. Complex or transsphincteric fistulas, especially in Crohn’s disease or after prior surgeries, require LIFT.
Is the LIFT procedure better than fistulotomy?
LIFT preserves sphincter function, with lower incontinence risk (1–5% vs. 10–30% for fistulotomy), but has a higher recurrence rate (10–30% vs. 2–10%). It’s ideal for complex fistulas.
Can fistulas heal without surgery?
Small fistulas may resolve with abscess drainage or antibiotics, but complex or transsphincteric fistulas typically require surgery like LIFT for closure.
How soon can I resume normal activities?
Light activities resume in 1–2 days; normal routines (work, driving) resume in 1–3 weeks.
Is the LIFT procedure covered by insurance in India?
Most insurance plans cover LIFT for symptomatic or complex fistulas. Confirm with your provider.
What are the signs of complications post-LIFT?
Persistent discharge, fever, severe pain, or difficulty controlling bowel movements require immediate medical attention.
Can fistulas recur after the LIFT procedure?
Recurrence occurs in 10–30% of cases, particularly in complex fistulas or Crohn’s disease, but repeat LIFT or alternative procedures can be effective.
What lifestyle changes are needed post-LIFT?
Maintain a high-fiber diet, stay hydrated, avoid straining during bowel movements, and practice good anal hygiene to prevent recurrence or infection.
Conclusion
The LIFT procedure is an effective, sphincter-sparing treatment for complex anal fistulas, offering high success rates and minimal risk of incontinence. With expertise in hospitals like Apollo, Fortis, and AIIMS, India provides affordable, high-quality colorectal care. By understanding the procedure, cost variations, recovery, risks, and FAQs, patients can approach LIFT with confidence. For personalized guidance, consult a colorectal surgeon at a reputed hospital to ensure timely and successful treatment.
Looking for Best Hospitals for LIFT Procedure
Note: we are not promoting any hospitals
we are not promoting any hospitals we sourced all the details from google and hospitals website, please verify and start with your surgery here we go the list includes government, budget and superspeciality hospitals accreditation bodies are the National Accreditation Board for Hospitals and Healthcare Providers (NABH) and the Joint Commission International (JCI)
- click on your city and schedule your surgery now done in good hands.
| City | Minimum Price (₹) | Maximum Price (₹) |
|---|---|---|
Agra |
40,000 |
1,00,000 |
Ahmedabad |
50,000 |
1,20,000 |
Ajmer |
40,000 |
1,00,000 |
Aligarh |
40,000 |
1,00,000 |
Allahabad |
40,000 |
1,00,000 |
Amritsar |
45,000 |
1,10,000 |
Aurangabad |
45,000 |
1,10,000 |
Bangalore |
50,000 |
1,20,000 |
Bareilly |
40,000 |
1,00,000 |
Belgaum |
45,000 |
1,10,000 |
Bhopal |
45,000 |
1,10,000 |
Bhubaneswar |
45,000 |
1,10,000 |
Bikaner |
40,000 |
1,00,000 |
Chandigarh |
50,000 |
1,20,000 |
Chennai |
50,000 |
1,20,000 |
Coimbatore |
50,000 |
1,20,000 |
Dehradun |
45,000 |
1,10,000 |
Delhi |
50,000 |
1,20,000 |
Dhanbad |
40,000 |
1,00,000 |
Durgapur |
40,000 |
1,00,000 |
Faridabad |
50,000 |
1,20,000 |
Ghaziabad |
50,000 |
1,20,000 |
Gorakhpur |
40,000 |
1,00,000 |
Guntur |
45,000 |
1,10,000 |
Gurgaon |
50,000 |
1,20,000 |
Guwahati |
45,000 |
1,10,000 |
Gwalior |
40,000 |
1,00,000 |
Hyderabad |
50,000 |
1,20,000 |
Indore |
45,000 |
1,10,000 |
Jabalpur |
40,000 |
1,00,000 |
Jaipur |
50,000 |
1,20,000 |
Jalandhar |
45,000 |
1,10,000 |
Jamshedpur |
45,000 |
1,10,000 |
Jodhpur |
40,000 |
1,00,000 |
Kanpur |
40,000 |
1,00,000 |
Kochi |
50,000 |
1,20,000 |
Kolkata |
50,000 |
1,20,000 |
Kollam |
45,000 |
1,10,000 |
Lucknow |
45,000 |
1,10,000 |
Ludhiana |
50,000 |
1,20,000 |
Madurai |
45,000 |
1,10,000 |
Mangalore |
45,000 |
1,10,000 |
Meerut |
40,000 |
1,00,000 |
Moradabad |
40,000 |
1,00,000 |
Mumbai |
50,000 |
1,20,000 |
Mysore |
50,000 |
1,20,000 |
Nagpur |
45,000 |
1,10,000 |
Nashik |
45,000 |
1,10,000 |
Navi Mumbai |
50,000 |
1,20,000 |
Noida |
50,000 |
1,20,000 |
Patna |
40,000 |
1,00,000 |
Pune |
50,000 |
1,20,000 |
Raipur |
45,000 |
1,10,000 |
Rajkot |
45,000 |
1,10,000 |
Ranchi |
40,000 |
1,00,000 |
Surat |
50,000 |
1,20,000 |
Thane |
50,000 |
1,20,000 |
Vadodara |
45,000 |
1,10,000 |
Varanasi |
40,000 |
1,00,000 |
Visakhapatnam |
45,000 |
1,10,000 |
Disclaimer
This information is sourced from open platforms and is for general awareness only. Costs may vary based on individual cases. Please consult a qualified doctor for medical advice and explore options within your budget before deciding on the procedure.