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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.
In conclusion, posterior complex horseshoe anal fistula can be safely and successfully treated. with modified Hanley procedure with the use of the hybrid elastic seton. Introduction. norectal fistula is an inflammatory. tract or abnormal connection. between the epitheliazed surface of the.