How is Advancement flap treatment done and what are disadvantages of this procedure?

Advancement flap is a method to reduce the amount of sphincter muscle cut. In this procedure, the tract is cored out and a flap is cut into the rectal wall to access and remove the fistula’s internal opening. The flap is then stitched back down.


This procedure has reasonable success rate up to

  • 80% in selected simpler cases
  • 75 % in fistulas with high risk of incontinence -Higher Fistulas & Women with anterior fistulas


  • Pain – This surgery leads to a large wound in the buttock which pains in the post operative period.
  • Invasive – The procedure is associated with cutting and scarring.
  • High expertise needed – The procedure needs higher level of expertise and is difficult to perform posteriorly.