Anal sphincter advancement flap for low transsphincteric anal fistula.

Laying open a transsphincteric anal fistula can be associated with risk of incontinence, especially in females. Therefore, an alternative option should be available to preserve the sphincter mechanism and cure the anal fistula. This article illustrates a new technique of using the distal part of the anal sphincter as an advancement flap to cover the internal opening and thereby effect a cure. In selected cases, anal sphincter advancement flap for low transsphincteric anal fistula is safe, effective, and has a low risk of incontinence.