is to improve the results of treatment of rectal fistula patients by improving the technical aspects of fistula excision. Materials and methods of research. A total of 134 cases were selected for a prospective dynamic active study. The first group, the Control group, included 56 (41.0%) patients in whom fistulas were dissected using conventional methods. The second group, the main group, included 78 (59.0%) patients in whom fistula dissection was performed using modified instruments. In the main group of patients sphincter-saving operations were performed. Results of the study. Patients who underwent LIFT surgery with the use of modified guides and without disruption of the muscle fibers of the anal ileum have a significant reduction in the level of pain syndrome in the postoperative period and after acts of defecation. This reduction in pain reduces the need for narcotic analgesics and significantly improves the quality of life of patients. Conclusions. The use of sphincter-saving surgical methods in the main group differs from traditional operations on fistula excision with subsequent suture of the sphincter, causing a shorter period of temporary disability - 18.9±3.6 days compared to 32.7±4.6 days; more favorable postoperative course with lower intensity of pain syndrome - 1,6±0,3 on VAS scale in Control with 6,0±0,2 points; shorter hospitalization - 10,1±2,2 days in Control with 17,4±3,1 days, and more effective postoperative rehabilitation of patients. These factors significantly improve the quality of life after surgery and contribute to lower financial costs to achieve successful treatment outcomes.