Advancement Flap Surgery
Rectal mucosal flap covering the internal fistula opening — sphincter-preserving surgery for high transsphincteric fistulas.
What is Advancement Flap Surgery?
Advancement flap surgery treats complex anal fistulas by closing the internal opening with a mobilised flap of healthy rectal mucosa, submucosa, and muscle. The flap is advanced over the closed internal opening, replacing diseased mucosa with vascularised healthy tissue.
Dr. Tagore Mohan Grandhi performs advancement flap surgery for high transsphincteric, suprasphincteric, and rectovaginal fistulas. No sphincter is divided at any point, making it suitable for complex fistulas where other sphincter-preserving options have failed.
Suitable for patients with high transsphincteric or suprasphincteric fistulas where other sphincter-preserving options have failed — or as a primary option for rectovaginal fistulas.
How the Procedure Works
Internal Opening Excision
Internal opening and surrounding diseased tissue excised. Fistula tract curetted. Rectal wall assessed for flap viability.
Flap Design
Trapezoidal or tongue-shaped flap of rectal mucosa, submucosa, and circular muscle designed with a wide vascular base above the internal opening.
Flap Mobilisation
Flap elevated and advanced downward to cover the closed internal opening defect under no tension.
Flap Suturing
Flap sutured to fresh well-vascularised edges covering the internal opening. External opening curetted and left open.
Healing
Sutures removed at 10–14 days. MRI at 3 months to confirm fistula closure.
Outcomes
Who Needs This Treatment?
- →Addresses internal opening directly with vascularised healthy tissue
- →No sphincter muscle divided — complete continence preservation
- →Applicable to high transsphincteric, suprasphincteric, and rectovaginal fistulas
- →60–80% cure rate in specialist hands
The advancement flap brings healthy, well-vascularised tissue directly to the internal fistula opening, closing the source of contamination with the best tissue available. In the right patient, the results are excellent.
— Dr. Tagore Mohan Grandhi, Senior Consultant Gastrointestinal Surgeon, Lux Hospitals, Hyderabad
Advancement Flap Surgery Cost for Anal Fissure in Hyderabad
The cost of Advancement Flap Surgery for Anal Fissure in Hyderabad depends on factors such as fissure location, severity, previous treatments, surgical complexity, and post-operative care requirements.
For patients with low-pressure fissures or those requiring an alternative approach after previous surgery, the approximate cost of Advancement Flap Surgery ranges between ₹45,000 and ₹85,000.
| Procedure | Approximate Cost Range |
|---|---|
| Advancement Flap Surgery | ₹45,000 – ₹85,000 |
The final cost may vary depending on your individual condition, surgical findings, hospital stay, and follow-up requirements.
Factors That Influence Advancement Flap Surgery Cost
The overall cost may depend on:
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Fissure characteristics: The location, chronicity, and healing pattern of the fissure can influence treatment planning.
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Previous treatment history: Patients with persistent symptoms despite earlier treatments may require additional evaluation and specialised surgical planning.
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Pre-operative evaluation: Clinical examination, medical assessments, and required investigations may contribute to the overall cost.
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Recovery and follow-up care: Wound care, medications, dietary guidance, and follow-up consultations may influence the overall treatment expense.
Is Advancement Flap Surgery Covered by Insurance?
Advancement Flap Surgery may be covered by health insurance when performed for a medically necessary condition. Coverage depends on your insurance policy, inclusions, and insurer approval process.
Our insurance support team can assist you with checking coverage eligibility, documentation requirements, and cashless approval procedures.
- Checking your policy coverage
- Cashless approval process
- Required documentation
- Insurance-related queries before the procedure
Dr. Tagore Grandhi
Orthopaedic & Joint Replacement Surgeon
During consultation, Dr. Samhitha Reddy, Proctologist at Lux Hospitals, will assess your fissure condition, previous treatment history, and overall health to determine whether Advancement Flap Surgery is appropriate. She will explain the procedure, expected outcomes, recovery process, and provide an estimated cost based on your individual condition and treatment requirements
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