Salvage Laparoscopic-Assisted Anorectoplasty after Failed Vestibular Fistula Repair Using Magnetic Resonance Image Guidance

• Main Authors: Matthew W. Ralls, Brian P. Fallon, Maria Ladino-Torres, Peter F. Ehrlich, Marcus D. Jarboe
• Format: Article
• Language: English
• Published: Georg Thieme Verlag KG 2019-01-01
• Series: European Journal of Pediatric Surgery Reports
• Subjects: posterior sagittal anorectoplasty; magnetic resonance imaging; image guidance; anorectal malformation; rectovestibular fistula
• Online Access: http://www.thieme-connect.de/DOI/DOI?10.1055/s-0039-1688486

Patients with vestibular fistula have a good functional outcome after posterior sagittal anorectoplasty (PSARP). While continence is often preserved, close follow-up and management of constipation are often required. Redo anorectal surgery has been associated with worse functional outcomes compared with primary procedures, possibly due to injury and scarring of the pelvic floor musculature and sphincter complex. Our group has a growing experience in the use of intraoperative real-time magnetic resonance imaging (MRI) for anorectal malformation repairs. We present a case of salvage operation of a failed PSARP for vestibular fistula.