Delorme’s procedure in rectal prolapse

  1. Diagnostic assessment; dissecting an anterior mucosal flap

    Video
    Diagnostic assessment; dissecting an anterior mucosal flap

    With the patient in lithotomy position, perform a digital rectal examination followed by slow and careful dilation of the anal sphincter. Insert the Parks retractor

    Injection into the anterior rectal mucosa, horizontal mucosal incision 5-8 mm proximal to the dentate line and careful excision of a longitudinally ovoid mucosal flap of up to 10 x 8 cm in size in cranial direction with diathermy while sparing the underlying muscle coat. Carry out the dissection in semicircular fashion, from 9 o'clock to 3 o'clock horizontally and vertically along the entire length of the rectocele.

  2. Plicating the muscle coat

    Video
    Plicating the muscle coat

    Gradually plicate the anterior rectal wall in the vertical direction with several absorbable sutures (size 0). This usually requires 5 - 8 stitches. The muscularis mucosae may be concertinaed or fixed in three layers.

  3. Resecting the mucosa

    Resecting the mucosa

    Resect the excess mucosa and then adapt the mucosal margins.

Suturing the mucosa

Adapt the mucosa with several interrupted sutures. ... - Operations in general, visceral and transp

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