REPAIR OF CONGENITAL H-TYPE VESTIBULOANORECTAL FISTULA THROUGH THE POSTERIOR MIDSAGITTAL APPROACH - CASE-REPORT

The posterior midsagittal approach was successfully used for the repai r of congenital H-type vestibuloanorectal fistula in a patient 1.5 mon ths old. Technical details of the operation which consisted of two mai n parts are described. Identification and dissection of the fistulous tract started following midsagittal division of the sphincters and the posterior half of the rectum with the patient in a knee-chest positio n. The dissected part of the fistulous tract was inverted per vagina. Completion of dissection and excision of the fistulous tract were acco mplished with the patient in the lithotomy position. The main advantag e of the procedure was the ability to completely excise the fistula un der direct vision.