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Related Concept Videos

Muscles of the Pelvic Floor and Perineum01:26

Muscles of the Pelvic Floor and Perineum

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The muscles of the pelvic floor and perineum are crucial for supporting the pelvic organs, controlling continence, and aiding in sexual function, childbirth, and core stability. They are typically divided into the superficial perineal layer and the deep pelvic floor layer.
Perineal Layer
The perineum is a diamond-shaped area below the pelvic diaphragm, divided into an anterior urogenital triangle that contains the external genitals and a posterior anal triangle housing the anus. The urogenital...
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Related Experiment Video

Updated: Dec 25, 2025

The Transition to an Anterior-Based Muscle Sparing Approach Improves Early Postoperative Function but is Associated with a Learning Curve
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Redo gracilis interposition for complex perineal fistulas.

H Gilshtein1, V Strassman1, S D Wexner2

  • 1Department of Colorectal Surgery, Cleveland Clinic Florida, 2950 Cleveland Clinic Blvd., Weston, FL, 33331, USA.

Techniques in Coloproctology
|March 28, 2020
PubMed
Summary
This summary is machine-generated.

Redo gracilis muscle interposition offers a feasible and safe approach for healing complex perineal fistulas. This technique shows promising results for persistent and recurrent cases.

Keywords:
Complex perineal fistulaGracilis muscle interpositionRedo

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Area of Science:

  • Surgical Reconstruction
  • Pelvic Floor Surgery
  • Fistula Treatment

Background:

  • Complex perineal fistulas, including rectovaginal, pouch-vaginal, and recto-urethral types, present significant treatment challenges.
  • Gracilis muscle interposition has demonstrated efficacy in managing these complex fistulas.
  • Persistent and recurrent cases necessitate evaluation of advanced surgical techniques.

Purpose of the Study:

  • To assess the feasibility and outcomes of performing a redo gracilis muscle interposition procedure.
  • To evaluate the effectiveness of this technique in treating persistent and recurrent complex perineal fistulas.

Main Methods:

  • A retrospective analysis was conducted on patients who underwent redo gracilis muscle interposition.
  • Data were collected from 1995 to 2019 at a single institution.
  • Patient demographics, fistula types, and outcomes were reviewed.

Main Results:

  • Nine patients (5 males, mean age 55 years) were included in the analysis.
  • The study included recto-urethral (n=5), rectovaginal (n=2), and pouch-vaginal (n=2) fistulas.
  • A 56% success rate was observed, with 5 patients achieving complete fistula healing. Postoperative complications occurred in only 1 patient (11%).

Conclusions:

  • Redo gracilis muscle interposition is a feasible and safe surgical option for complex perineal fistulas.
  • The procedure demonstrates promising results in achieving fistula healing, even in recurrent cases.
  • This technique offers a viable solution for challenging perineal fistula management.