Why Unnecessary Wide Excision in Fistula in ano?
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Transcript of Why Unnecessary Wide Excision in Fistula in ano?
![Page 1: Why Unnecessary Wide Excision in Fistula in ano?](https://reader037.fdocuments.in/reader037/viewer/2022102716/554b27eab4c905ce088b488b/html5/thumbnails/1.jpg)
Fistula in anoWhy Unnecessary Wide Excision?
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Peri-anal Fat is precious, Anal Musculature is complex and indispensible, So Why unnecessary and over enthusiastic excision of precious tissue?
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Previous surgery with seton in situ – large isheorectal abcess right side
Case 1
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Laying open of tract with seton placement
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Incision and drainage of abscess – cavity communicating with internal opening
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Probing
Case 2
External opening
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Methylene Blue injection –
no external opening
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Coring
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Excision of tract till blind end – bone
palpable
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Packing of wound
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Case 3
Multiple external openings - Probing
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Laying open tract
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Anterior horse shoe type fistula – lay open –
internal opening at 6 o clock.
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Seton placement – partial sututing of
open wound
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Case 4
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Coring of two external openings
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Opening made at 6 o clock position
with seton placement
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Case 5
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MRI gluteal regionComplex grade V intersphintric
translevator perianal fistula with two external openings on right side and opening in translevator area on right side after crossing midline
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Probing
Joining two external openings
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Internal opening at 6 o clock
Lay open tract – seton placement
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Is it avoidable?Yes I shall come up with
solutions in next presentation.