Dear Yonko, several years ago we were the third hospital in Germany using the OTSC clip. We used it about 10 times and leaved this techinque in the meanwhile. Reasons: clip loss and plain. We use Permacol Paste instead now.

Thank you dr Benesch 

WE DONT USE IT

I don't use it

I combine a fistulectomy with  a rectal advancement flap  and a Cook fistula plug and have a succes rate of 75 %. The first 30 cases are in press, albeit in the Acta chirurgica belgica because " Colorectal disease turned it down. The OTSC was proposed to me but I am reluctant to use because  of 1° its cost and 2° it's  fate . What happens when this huge thing stays clinged in the anal canal.  As Dr. Benesch states I guess it can be  painful . How do you get rid of it  when it's not useful anymore ????