Surgical treatment of high imperforate anus with definition of the puborectalis sling by an anterior perineal approach.

An operative technique in which the sling of the puborectalis muscle is seen through an anterior perineal approach in the treatment of high imperforate anus is described. The operation has been performed, on children with previous colostomies, and on older children with unsuccessful previous abdomino-perineal pull-through procedures. While our series of patients is still small, 24 children, operated upon sufficiently long ago for follow-up purposes, have generally shown good to excellent functional results.