With the patient in lithotomy position, perform a digital rectal examination followed by slow and careful dilation of the anal sphincter. Insert the Parks retractor After careful retrograde probing and instillation of contrast agent, the inner internal opening of the fistula is found high in the anal canal at 5 o'clock.
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Assessing the fistula
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Excising the external opening of the fistula
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Dissecting the fistula from ischioanal fatty tissue
Dissecting the fistula at the external anal sphincter
For the medial dissection tightly follow the external margin of the anal sphincter. ... - Operation
For the medial dissection tightly follow the external margin of the anal sphincter. ... - Operation
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