Anal fistula, plastic closure with rectal mucosa advancement flap

  1. Exploring and inspecting the fistula

    Video
    Exploring and inspecting the fistula

    First inspect the non-infected healed fistula with its previously inserted seton. Probe the fistula through its external opening and perform a digital rectal examination.

  2. Excising the external fistula opening

    Video
    Excising the external fistula opening

    Now start with the funnel-shaped excision of the fistula along its track.

  3. Excising the internal fistula opening

    Video
    Excising the internal fistula opening

    Insert the anal retractor and dissect the internal opening of the fistula. Follow the fistula track and sparingly excise the internal fistula opening.

Dissecting the advancement flap

With the electric diathermy carefully dissect the mucosal flap required to cover the defect. ... -

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general and visceral surgery

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