Fistulectomy with primary anal sphincter reconstruction

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. Now insert the Parks retractor.

In order to ensure a wide external wound for drainage, generously excise the external opening of the fistula and then core out the fistula tract like a funnel along the seton.

Divide the anal sphincter completely along the fistula-bearing part.

Tip: Use the previously inserted probe as a guide.