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.

ADVANTAGES

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

DISADVANTAGES

• 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.