This is a novel technique conceived and initially proposed by colorectal surgeons from a large referral center in Thailand, which gradually became widely accepted all over the world. It is an ingenious sphincter-sparing approach to the surgical management of transsphincteric fistula which continues to be used in practice although the reported success rate has not been as high as in this original publication. The ligation of the intersphincteric tract has been more recently proposed also in selected patients with transsphincteric fistulas associated with Crohn’s disease.