Endorectal / Endoanal Advancement Flap
A flap of healthy rectal tissue is advanced to close the internal fistula opening - the preferred sphincter-preserving surgical option for high and complex anal fistulas where sphincter division would risk incontinence.
What is Endorectal / Endoanal Advancement Flap?
The Endorectal Advancement Flap procedure closes the internal opening of a high or complex anal fistula by advancing a well-vascularised flap of healthy rectal mucosa and submucosal tissue to seal it. The external opening is separately curetted. The sphincter is completely preserved - making it one of the best sphincter-safe options for complex anal fistula surgery in Hyderabad.
Dr. Samhitha Reddy performs advancement flap repair at Lux Hospitals, Hyderabad for high trans-sphincteric, suprasphincteric, and recurrent fistulas where other sphincter-preserving options have failed or are unsuitable. It is also a primary option for fistulas associated with Crohn's disease - as part of the comprehensive cost-effective fistula care in Hyderabad programme.
Advancement flap success depends on patient factors including prior radiation, Crohn's disease activity, and tissue quality. Active infection must be fully controlled (via seton drainage) before flap repair is attempted.
How the Procedure Works
Seton Phase (If Needed)
A draining seton is placed for 6–12 weeks if active infection or induration is present - resolving inflammation before the flap repair.
Flap Design
Under spinal or general anaesthesia, a U-shaped or trapezoidal flap of mucosa, submucosa, and a portion of the internal sphincter is designed above the internal opening.
Flap Elevation
The flap is carefully elevated, preserving its blood supply. The internal opening is curetted and the flap base is mobilised.
Internal Opening Closure
The internal opening is closed. The flap is advanced distally to cover the closed opening and sutured in place without tension.
External Tract Curettage
The external fistula tract is curetted through the external opening. External opening left open to drain. High-fibre diet and stool softeners prescribed post-operatively.
Outcomes
Who Needs This Treatment?
- →Sphincter completely preserved - appropriate for fistulas involving significant sphincter muscle
- →Brings healthy well-vascularised tissue to close the internal opening - critical for complex fistulas
- →Preferred option for Crohn's-related complex fistulas in Hyderabad
- →Can be performed after prior failed fistula surgery without compromising future options
- →No prosthetic material required - purely autologous tissue
- →Available at Lux Hospitals, Hyderabad as part of the leading fistula clinic programme
The advancement flap is one of the most technically satisfying procedures in colorectal surgery. When executed correctly with a tension-free closure of the internal opening, it provides durable closure even for the most complex fistulas - with the sphincter completely untouched.
— Dr. Samhitha Reddy, Consultant Proctologist & Laparoscopic Surgeon, Lux Hospitals, Hyderabad
Endorectal / Endoanal Advancement Flap Cost in Hyderabad
The cost of Endorectal / Endoanal Advancement Flap procedure in Hyderabad depends on the type of fistula, complexity of the tract, whether the condition is recurrent, investigations required, and the care needed before and after surgery.
For conditions such as high or recurrent anal fistula, where an advancement flap procedure may be recommended, the approximate cost ranges between ₹50,000 and ₹1,00,000.
| Procedure | Approximate Cost Range |
|---|---|
| Endorectal / Endoanal Advancement Flap High, Recurrent Fistula | ₹50,000 – ₹1,00,000 |
The final cost may vary depending on your individual condition, fistula tract characteristics, findings during evaluation, and whether any additional procedures or post-operative care are required.
Factors That Influence Endorectal / Endoanal Advancement Flap Cost
The overall cost may depend on:
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Type and complexity of fistula: The height of the fistula tract, recurrence history, involvement of surrounding tissues, and complexity of the condition can influence the surgical approach and cost.
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Pre-operative evaluation: Required investigations, clinical examination, imaging tests, and medical assessments before surgery may affect the overall cost.
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Additional procedures: If procedures such as abscess drainage, seton placement, fistula mapping, or treatment for associated anorectal conditions are required along with advancement flap repair, the cost may vary.
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Hospital stay and post-operative care: The duration of admission, medicines, wound care, follow-up consultations, and recovery support may influence the final estimate.
Is Endorectal / Endoanal Advancement Flap Covered by Insurance?
Endorectal / Endoanal Advancement Flap procedure may be covered by health insurance when it is performed for a medically necessary condition. Coverage depends on your insurance policy, inclusions, waiting periods, and approval process.
Our insurance support team can assist you with checking your policy coverage, required documentation, cashless approval process, and insurance-related queries before the procedure.
- Checking your policy coverage
- Cashless approval process
- Required documentation
- Insurance-related queries before the procedure
Dr. Samhitha Reddy
Consultant Proctologist & Laparoscopic Surgeon
During consultation, Dr. Samhitha Reddy, Proctologist and Colorectal Surgeon in Hyderabad, will evaluate your symptoms, fistula type, medical history, and examination findings to determine whether an advancement flap procedure is suitable for you. She will explain the procedure, expected recovery, and guide you regarding the estimated cost based on your individual condition and treatment requirements.
Common Questions
Frequently Asked Questions
Not sure which treatment is right for you?
Book a consultation with Dr. Samhitha Reddy and get a personalised treatment plan.