Transanal full thickness rectal mobilization with an ischiorectal fat pad to repair an H-Type rectovaginal fistula

Video Type: CVideo
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Author: Carlos Reck
Published:
Specialties: Pediatric Surgery
Schools: Nationwide Children’s Hospital Department of Pediatric Surgery Center for Colorectal and Pelvic Reconstruction Columbus - Ohio
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Basic Info

Transanal full thickness rectal mobilization with an ischiorectal fat pad to repair an H-Type rectovaginal fistula.

Contributors: Alejandra Vilanova, Richard Wood, Victoria Lane, and Marc Levitt

Advanced

Procedure

Transanal full thickness rectal mobilization with an ischiorectal fat pad to repair an H-Type rectovaginal fistula 
Indications.

Indications

Acquired H-Type fistula in patients with AIDS and no treatment.

Contraindications

Instrumentation

Setup

Prone position.

Preoperative Workup

Contrast enema
Exam under anesthesia demonstrating the fistula

Anatomy and Landmarks

Fistula going from the crypt to the vagina

Advantages/Disadvantages

Advantage: Minimal rate of recurrence of fistula when compared to other techniques
Disadvantage: Experience with PSARP needed to safely perform this procedure

Complications/Risks

Risk of stricture
Risk of fistula recurrence

Disclosure of Conflicts

None

Acknowledgements

None

References

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