Contemporary surgical management of rectovaginal fistula in Crohn's disease

Figure 5 Martius graft. The martius graft begins standard perineal dissection followed by longitudinal incision over the labia majora. Skin flaps are raised medially and laterally until entire fat pad with bulbocavernosus muscle is mobilized. A subcutaneous, subvaginal tunnel is made and the flap is pulled through the tunnel after the anterior end is divided and then sutured to the posterior vaginal wall. Reprinted with permission, Cleveland Clinic Center for Medical Art and Photography © 1999-2014. All Rights Reserved.