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Related Experiment Videos

How I do it: Martius flap for rectovaginal fistulas.

Kevin Kniery¹, Eric K Johnson, Scott R Steele

¹Department of Surgery, Division of Colorectal Surgery, Madigan Army Medical Center, 9040 Jackson Ave, Tacoma, WA, 98431, USA.

Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract

|December 19, 2014

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The Martius technique, using bulbocavernosus muscle, offers a viable surgical option for complex rectovaginal fistulas. This method brings healthy tissue to aid closure in challenging cases.

Area of Science:

Surgical reconstruction
Pelvic floor anatomy

Background:

Rectovaginal fistulas (RVFs) pose significant challenges for patients and surgeons.
Existing surgical options include flaps, plugs, and reconstruction, with varying success rates.

Observation:

Recurrent or complex RVFs, particularly after radiation or in Crohn's disease, require advanced techniques.
The bulbocavernosus muscle pedicle, described by Martius, provides a source of healthy, vascularized tissue.

Findings:

The Martius technique utilizes the bulbocavernosus muscle and its vascularized pedicle for RVF closure.
This method is particularly beneficial for complex cases with large wounds or prior radiation therapy.

Implications:

Incorporating the Martius technique into surgical armamentarium can improve outcomes for challenging RVF cases.

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Awareness of this reconstructive option is crucial for surgeons managing these difficult conditions.