Gracilis Transposition: Treating Complex Perineal Fistulas (Video)

A step-by-step look at the procedure in men and women

Gracilis transposition is an effective technique for repairing complex perineal fistulas in either gender (rectovaginal fistulas in women and rectourethral fistulas in men).

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In this video, Steven Wexner, MD, Director of the Digestive Disease Center and Chair of Colorectal Surgery at Cleveland Clinic Florida, explains the procedure step by step. Watch Dr. Wexner:

  1. Harvest the gracilis muscle and tunnel it to the perineum
  2. Dissect the perineum
  3. Debride the fistula
  4. Interpose the gracilis muscle
  5. Close the rectal opening and vaginal or urethral defect