Anterior perineal anorectoplasty for intermediate and high imperforate anus

Anterior perineal anorectoplasty is a new technique for the repair of high imperforate anus. This technique allows direct access and clear visualization of the puborectalis sling and rectal pouch; division of the fistula and mobilization of the rectum can be precisely performed under direct vision, thereby reducing injury to surrounding structures; the pull-through of the rectum is readily facilitated; it obviates the need to change the position of the patient during the procedure; and mobilization of the rectum required to pull the rectum through is minimal, hence the late complication of mucosal prolapse is avoided. Details of the operative procedure are described herein.