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Horseshoe fistula is one of the most. complex and potentially morbid. conditions faced in a modern anorectal. surgery. Hanley, 1965 reported his. original procedure for horseshoe fistula. which involved complete division of the. posterior 12 o'clock sphincter mechanism.
An anal fistula is an abnormal connection between the anal. canal and the skin near the anus. It has an entrance in the. anal canal (internal opening) and an exit on the skin near. the anus (external opening). The fistula itself is a tunnel or. tube connecting the internal and external openings which. crosses the anal sphincter muscles. Most anal fistulas. follow an anal abscess.