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
![Assessing the fistula]()
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Excising the external opening of the fistula
After carefully debriding the fistula tract, excise the tissue around the external opening. The ind
After carefully debriding the fistula tract, excise the tissue around the external opening. The ind
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