The LIFT (ligation of the intersphincteric fistula tract) procedure for a transsphincteric posterior anal fistula – a video vignette doi:10.1111/codi.15096 Dear Editor, Anal fistulas are one of the most common anorectal conditions, with a prevalence of 8.6 cases per 100 000 population [1]. Sphincter-sparing procedures have been described for the treatment of complex anal fistulas, including seton drainage, laser ablation, ligation of the intersphincteric fistula tract (LIFT), fistula plug and video-assisted anal fistula treatment [2]. The LIFT pro- cedure was introduced in 2007 as a sphincter-preserving operation for transsphincteric anal fistula [3]. Recent systemic reviews and meta-analyses have reported a pooled success rate of up to 76.5% and a risk of faecal incontinence of around 1.4% [2,4]. We present the case of a 64-year-old female patient who presented to our clinic with a persistent perianal fistula. In 2017 she underwent surgery for a perianal abscess. Later she developed a symptomatic fistula. On palpation, the external opening was seen at 5 o’clock. Magnetic resonance imaging was not indicated as it was a simple transsphincteric fistula. The patient underwent a LIFT procedure under gen- eral anaesthesia (Video S1). The postoperative course was uneventful and the patient was discharged on the first postoperative day. A month later, the patient was contacted by phone due to the current COVID-19 pan- demic. She had no complaints or perianal discharge. The LIFT procedure can be considered an effective sphincter-sparing procedure in the management of a transsphincteric fistula, with an acceptable outcome. Conflicts of interest The authors declare that no conflicts of interest exist. The authors declare that they have no competing interests. The authors alone are responsible for the content and writing of the paper. The authors declare that this video vignette has not been published elsewhere and that it has not been submitted previously for publication elsewhere. Ethical approval All procedures involving human participants were per- formed in accordance with the ethical standards of the institutional and/or national research committee and the 1964 Declaration of Helsinki and its later amend- ments or comparable ethical standards. This article does not contain any studies using animals. Informed consent Informed consent was obtained from the patient. N. E. Samalavicius*†, V. Klimasauskiene*, V. Nausediene*, V. Cereska* and A. Dulskas†‡§ *Department of Surgery, Klaipeda University Hospital, Klaipeda, Lithuania; †Faculty of Medicine, Institute of Clinical Medicine, Vilnius University, Vilnius, Lithuania; ‡Department of General and Abdominal Surgery and Oncology, National Cancer Institute, Vilnius, Lithuania, and §Faculty of Health Care, University of Applied Sciences, Vilnius, Lithuania E-mail: audrius.dulskas@gmail.com Received 2 April 2020; accepted 20 April 2020; Accepted Article online 30 April 2020 References 1 Poggio JL. Fistula-in-ano, 2018. Medscape. https://emedic ine.medscape.com/article/190234-overview. (accessed March 2020). 2 Emile SH, Khan SM, Adejumo A, Koroye O. Ligation of intersphincteric fistula tract (LIFT) in treatment of anal fis- tula: an updated systematic review, meta-analysis, and meta- regression of the predictors of failure. Surgery 2020; 167: 484–92. 3 Rojanasakul A, Pattanaarun J, Sahakitrungruang C, Tan- tiphlachiva K. Total anal sphincter saving technique for fis- tula-in-ano; the ligation of intersphincteric fistula tract. J Med Assoc Thai 2007; 90: 581–6. 4 Yassin NA, Hammond TM, Lunniss PJ, Phillips RK. Liga- tion of the intersphincteric fistula tract in the management of anal fistula: a systematic review. Colorectal Dis 2013; 15: 527–35. Supporting Information The video may be found in the online version of this article and also on the Colorectal Disease Journal YouTube and Vimeo channels: Video S1. LIFT procedure for transsphincteric poste- rior anal fistula. Colorectal Disease ª 2020 The Association of Coloproctology of Great Britain and Ireland 1 Correspondence