Operation

Various issues regarding pouch construction can affect pouch reach. General pouch configuration tends to be with J-pouches these days, they are simple to construct, the W-pouch is larger, but the S-pouch may reach further. Hand sewn, pouch anal anastomosis is somewhat more skilled than the stapled pouch. The stapled pouch gives a degree of extra length. There remains the issue of whether the pouch will indeed reach the anus. This video explores the surgical methods to ensure pouch length in this …

This one hour documentary explores the management of fistula in ano and is directed at senior surgical trainees, specialist surgeons and consultants. Prof. Clive Bartram leads the discussion on the role of radiology and is joined by Steve Halligan (MRI) and Mr Gordon Buchanan (3D endoanal ultrasound). Prof. Robin Phillips discusses the strategy behind anal fistula surgery and demonstrates the clinical features and surgery in various cases. The complex anatomy of the anal canal and the intimate …