Female - No fistula

This is a female infant with an anorectal malformation and there is no fistula. On the distal callostogram, the rectum is blind ending. The perineum is inspected and the presence of a vagina is confirmed. The muscle stimulator shows the center of the sphincter mechanism here, and this is marked with ink. A posterior sagittal incision is made through the center of the sphincter mechanism and retracting pins are inserted. The rectum is low and is identified here, and the lumen is entered. Silk sutures are inserted to assist in the dissection by allowing uniform traction on the tissues. Mobilization of the rectum is started on the lateral wall. And then once the plane of dissection is identified, the dissection moves to the anterior wall and the rectum is mobilized off the vagina. Once adequate length is achieved, a standard anoplasty is performed, the posterior border of the muscle complex is marked with ink. Phooabsorbable suture is used to tack the rectum to the posterior border of the muscle complex. The rectum is trimmed. And the anoplasty is completed.