From
Dr. Nelson G. Rosen
Perineal body-preserving PSARP versus classic approach: expert panel discussion
With Dr. Nelson G. Rosen · hosted by Dr. Jill Knepprath
Chapter 1 of 4
Introduction
Introduction and Topic Overview
Expert statements on this page
No expert statements were drawn from this page.
Host summaries · secondary, not cited in answers
Educational content from recorded physician discussions — not medical advice. Talk to your (or your child's) care team about your situation.
Video
Validation of an anorectal malformation trainer - Can a high-fidelity model simulate real life?
1 min · Published Jun 2026
Podcast
Colorectal Quiz: Episode 2
Marc Levitt · 18 min · Published Jan 2021
Video
Rectal Prolapse Repair Following a Posterior Sagittal Anorectoplasty
4 min · Published Jan 2025
Video
Update Course Rewind 2025: Hirschsprung + ARM: Rare but Real
1 min · Published May 2026
Video
Posterior Rectal Advancement Anoplasty (PRAA) in a male with an anorectal malformation and rectoperineal fistula
9 min · Published Mar 2026
Podcast
Colorectal Quiz Episode 2: When to redo a PSARP
18 min · Published Jan 2021
More from this expert
Dr. Nelson G. RosenPodcast
Timing of PSARP for rectal vestibular fistulas: early versus delayed repair
Nelson G. Rosen · 3 min · Published Nov 2026
Video
Evaluation and management of pilonidal disease in adolescents
Nelson G. Rosen · 43 min · Published Sep 2025
Video
Single incision laparoscopic appendectomy technique and instrumentation
Nelson G. Rosen · 11 min · Published May 2024
Video
Diagnostic workup for Hirschsprung disease in newborns and children
Nelson G. Rosen · 10 min · Published Jul 2021
Video
Hirschsprung-Associated Enterocolitis: Recognition and Treatment
Nelson G. Rosen · 2 min · Published Jul 2019
What the experts said
Perineal body–preserving PSARP technique is essentially the same approach used for bulbar fistula but applied to vestibular fistula, cleaning up lateral planes before coming around the front.
Perineal body–preserving PSARP allows earlier discharge because surgeons are not concerned about perineal body breakdown postoperatively.
Perineal body–preserving PSARP is technically harder than opening all the way anteriorly in classic PSARP.
If uncertain about the location of the anterior rectal wall or vagina during perineal body–preserving PSARP, conversion to standard PSARP is appropriate.
Audience poll showed many surgeons performing perineal body–preserving PSARP, with classic PSARP a close second, and some still using anterior sagittal approach.
2023 publications on perineal body–preserving PSARP demonstrated at one-year follow-up: no dehiscence, no prolapse, and only 13% of patients required revision of anal stricture.
Two-thirds of patients undergoing perineal body–preserving PSARP went home on postoperative day one.