Transverse pelvic floor division for the posterior approach to the rectum and anus.

The posterior approach to the rectum can be enhanced by a transverse division of the pelvic floor muscles. In a series of 51 patients the pelvic floor between the anus and the coccyx was opened in a transverse direction giving access to the pelvirectal space and the sphincter muscles. The approach which enabled an extensive exposure was used for posterior rectotomy (10 cases), nodal excision from the mesorectum and lateral ligaments (2 cases), postanal repair (3 cases), exploration or excision of complex high and fistula (4 cases), abdomino-trans-sphincteric resection of rectal carcinoma (13 cases) and local excision (19 cases). The results with respect to wound healing and anorectal function were satisfactory.