Elective versus emergency full‐thickness rectal prolapse treatment using a perineal approach – a video vignette
- 26 April 2020
- journal article
- letter
- Published by Wiley in Colorectal Disease
- Vol. 22 (10), 00-1464
- https://doi.org/10.1111/codi.15092
Abstract
Altemeier’s procedure is a well‐known operation that can be performed under spinal anaesthesia, avoiding the trauma of a laparotomy, reducing the surgical stress and allowing a rapid recovery of patients[1]. Usually patients with full‐thickness rectal prolapse are investigated before the elective surgery and undergo preoperative assessment starting with a clinical examination and then further investigations including pelvic MRI, dynamic defecography and anorectal manometry[2]. All contribute to the decision to carry out a safe and “standard” perineal rectosigmoidectomy. However, these cannot be performed as an emergency if the prolapse becomes strangulated or incarcerated [3]. Although the Altemeier’s procedure has been demonstrated to be useful and effective in the emergency situation, the key steps of the technique need to be modified according to this different clinical scenario [4, 5]. In this video we demonstrate the perineal recto‐sigmoidectomy in the elective and an emergency situation and highlight the main differences in surgical technique.This publication has 5 references indexed in Scilit:
- Emergency perineal rectosigmoidectomy (Altemeier procedure) for strangulated rectal prolapse – a video vignetteColorectal Disease, 2019
- Perineal Rectosigmoidectomy (Altemeier Procedure) as Treatment of Strangulated Rectal ProlapseJournal of Gastrointestinal Surgery, 2016
- Long-Term Outcome of Altemeier's Procedure for Rectal ProlapseDiseases of the Colon & Rectum, 2009
- Perineal rectosigmoidectomy (Altemeier's procedure): a review of physiology, technique and outcomeTechniques in Coloproctology, 2002
- Management of acute incarcerated rectal prolapseDiseases of the Colon & Rectum, 1992