Perineal rectosigmoidectomy – Altemeier procedure - general and visceral surgery
You have not purchased a license - paywall is active: to the product selection
Inserting the anal retractor and incising the rectal wall
After completely exposing the external prolapse attach the Lone Star retractor and expose the dentate line. Then a circular incision of the outer duplication of the rectal wall 1-2 cm above the dentate line is made under gentle traction at the tip of the prolapse with Allis clamps, so that the anastomosis is later proximal to the puborectal muscle.
Transect the outer duplication of the rectal wall
Step by step, transect the rectal wall with bipolar scissors. At each exposed part of this incision, grasp the caudal rectal wall and place Gambee sutures without tying them.
Note: Make the first full-thickness stitch of the absorbable multifilament suture from the submucosa to the inside and the return stitch from the inside to the outside. Put tension on the ends of the suture to open up the anal ring in circular fashion.Opening the pouch of Douglas and transecting the lateral ligaments
Transecting the mesorectum
Pelvic floor repair
Resecting the sigmoid
Anastomosis; specimen
Single Access
Access to this lecture
for 3 days
€4.99 inclusive VAT

webop-Account Single
full access to all lectures
price per month
for the modul: vascular surgery