Anal fistula, plastic closure with rectal mucosa advancement flap - general and visceral surgery

You have not purchased a license - paywall is active: to the product selection
  1. Exploring and inspecting the fistula
  2. Excising the external fistula opening
  3. Excising the internal fistula opening
  4. Dissecting the advancement flap
  5. Suturing the internal fistula opening
  6. Advancement flap
date of publication: 26.04.2009

Single Access

Access to this lecture
for 3 days

€4.99 inclusive VAT

SEPA Maestro Mastercard VISA

webop-Account Single

full access to all lectures
price per month

for the modul: vascular surgery

from 8,17 €

ask it here

hospitals & libraries

for the modul: vascular surgery

from 390,00 euros

ask it here

  • Exploring and inspecting the fistula

    Video
     
    52-4

    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.

  • Excising the external fistula opening

    Video
     
    52-5

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

  • Excising the internal fistula opening

    Paid content (video)
    Paid content (image)

    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

    Paid content (video)
    Paid content (image)

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

  • Suturing the internal fistula opening

    Paid content (video)
    Paid content (image)

    Close the internal fistula opening with full-thickness sutures, while the external fistula opening is left to heal by second intention.

  • Advancement flap

    Paid content (video)
    Paid content (image)

    Cover the rectoanal defect with the previously prepared mucosal flap and secure it with several interrupted sutures. At the end carry out a final inspection.