Endorectal / Endoanal Advancement Flap
Sphincter-sparing surgery for complex fistulas — a flap of healthy rectal tissue is mobilised and used to cover and close the internal opening of the fistula.
What is Endorectal / Endoanal Advancement Flap?
Endorectal / Endoanal Advancement Flap is a sphincter-sparing surgical technique for complex anal fistulas, particularly high transsphincteric, suprasphincteric, or recto-vaginal fistulas. A flap of healthy rectal mucosa and submucosa is carefully mobilised and advanced down to cover and close the internal opening of the fistula. This protects the sphincter muscle while providing healthy, well-vascularised tissue to seal the tract. As a female proctologist in Hyderabad, Dr. Tejasree Vengala performs advancement flap surgery at Lux Hospitals, Hyderabad, particularly valuable for complex fistulas in women.
How the Procedure Works
Anaesthesia & Positioning
Surgery is performed under spinal or general anaesthesia. The patient is positioned in lithotomy or prone position.
Examination & Tract Mapping
The internal and external openings are clearly identified, and the full course of the fistula tract is mapped.
Tract Curettage & Closure
The fistula tract is curetted, and the internal opening is carefully closed in layers with absorbable sutures.
Flap Mobilisation & Advancement
A broad-based flap of healthy rectal mucosa and submucosa is mobilised and advanced down to cover the closed internal opening tension-free.
Recovery & Discharge
Patients are discharged in 1–2 days with structured wound care, dietary advice, and a clear follow-up plan.
Outcomes
Who Needs This Treatment?
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Complete sphincter preservation — full continence maintained
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Effective for complex and recurrent fistulas
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Well-vascularised flap promotes durable healing
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Particularly useful for recto-vaginal fistulas
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Reliable option in Crohn's-related fistulas
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Discreet, sensitive care by a female proctologist
The advancement flap is one of the most elegant operations in proctology — bringing healthy, well-vascularised tissue down to seal a difficult fistula while protecting every fibre of the sphincter. For women with recto-vaginal or complex fistulas especially, it is often the most thoughtful, dignified choice.
— — Dr. Tejasree Vengala, Consultant Proctologist & Laparoscopic Surgeon, Lux Hospitals, Hyderabad
Endorectal / Endoanal Advancement Flap Cost in Hyderabad
The cost of endorectal/endoanal advancement flap surgery in Hyderabad depends on the complexity and location of the anal fistula, involvement of the anal sphincter, whether the fistula is recurrent, investigations required, and the care needed before and after surgery.
For patients requiring an advancement flap for suitable complex or recurrent anal fistulas, the approximate cost ranges between ₹80,000 and ₹1,50,000.
| Procedure | Approximate Cost Range |
|---|---|
| Endorectal / Endoanal Advancement Flap | ₹80,000 – ₹1,50,000 |
The final cost may vary depending on your individual condition, findings during evaluation, fistula complexity, previous treatments, and whether any additional procedures are required.
Factors That Influence Endorectal / Endoanal Advancement Flap Cost The overall cost may depend on:
The overall cost may depend on:
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Type and complexity of fistula: The location, number of tracts, sphincter involvement, recurrence, and complexity of the fistula may influence treatment planning and surgical complexity.
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Pre-operative evaluation: Required clinical examination, MRI or other imaging when needed, and medical assessments before surgery may affect the overall cost.
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Additional procedures: If procedures such as seton placement, abscess drainage, fistula tract treatment, or other proctology interventions are required along with the advancement flap, the cost may vary.
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Hospital stay and post-operative care: The duration of admission, medicines, wound care, dietary guidance, and follow-up requirements may influence the final estimate.
Is Endorectal / Endoanal Advancement Flap Covered by Insurance?
Endorectal / endoanal advancement flap surgery may be covered by health insurance when it is performed for a medically necessary anal fistula. Coverage depends on your insurance policy, inclusions, 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. Tejasree Vengala
Consultant Proctologist & Laparoscopic Surgeon
During consultation, Dr. Tejashree Vengala, General & Laparoscopic Surgeon in Hyderabad, will evaluate your symptoms, medical history, and examination findings to determine whether an advancement flap procedure is suitable for you. She will explain the procedure, expected outcomes, and guide you regarding the estimated cost based on your individual condition and treatment requirements.
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