In lithotomy position, anorectal-digital exploration and cautious, slow manual sphincter dilation. Then insertion of the Parks retractor. After careful, retrograde probing and contrast application, the internal fistula opening is found high in the anal canal at the 5 o'clock lithotomy position.
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Examination
![Examination]()
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Excision of the External Fistula Opening
![Excision of the External Fistula Opening]()
Soundsettings First, the excision of the external fistula opening is performed. Here, one can be guided by the induration of the ischioanal tissue. The goal is a funnel-shaped wound with a wide opening.
Preparation of the Fistula from the Ischioanal Fat Tissue
Lateral incision is made where the tissue becomes soft, meaning it is not inflamed or scarred. ...
Lateral incision is made where the tissue becomes soft, meaning it is not inflamed or scarred. ...
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