I.Hastie approach
GTN 6weeks
R/v @ 4weeks
If no improvement, book for Botox
Botox twice, then sphincterotomy
Parkes Retractor
Paplate groove between int and ext sphincter
Radial incision over internal sphincter
Spaces each side of sphincter opened up
Divide internal sphincter up to dentate line only (no mre than half of int sphincter)
Failure to heal in 5% - do other side
Friday, September 14, 2007
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