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Turnbull-Cutait Pull Through for Recto-Vaginal Fistula
Joseph Garvin^*, Jean Ashburn, Feza H. Remzi
Colorectal Surgery, Digestive Disease Institute, Cleveland Clinic, Cleveland, OH

This video demonstrates the utility of the Turnbull-Cutait abdominoperineal colonic pull through in the management of a complex recto-vaginal fistula. The patient presented with a fistula having previously undergone a low anterior resection for rectal cancer with preoperative chemoradiotherapy. A symptomatic vaginal fistula developed following closure of defunctioning ileostomy. We demonstrate the techniques used in this procedure including colonic mobilization, excision of phlegmon, mucosectomy, excision of scar tissue, staged placement of the anal sutures, tissue placement in order to prevent recurrence and acceptance of a degree of ectropion in order to prevent retraction and stricture.

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