Laparoscopic Suture Rectopexy with Culdoplasty, Vaginal Wall Repair, and Perineorrhaphy for Rectal Prolapse
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1,2; 1,2*; 1,3*
1Pelvic Floor Disorders Center, Massachusetts General Hospital, Boston, MA
2Department of Obstetrics, Gynecology and Reproductive Biology, Massachusetts General Hospital, Boston, MA
3Section of Colorectal Surgery, Department of Surgery, Massachusetts General Hospital, Boston, MA
*Operating Surgeons
Procedure Outline
Table of Contents
- 1. Introduction
- 2. Surgical Approach and Laparoscopic Access
- 3. Reduce Bowel out of Pelvis
- 4. Preparation of Sacral Promontory for Sutures
- 5. Rectum Mobilization
- 6. Suture
- 7. Review Progress
- 8. Approach to Culdoplasty
- 9. Culdoplasty
- 10. Reconstruct Pouch of Douglas
- 11. Finish Closing Peritoneum
- 12. Perineorrhaphy and Levator Plication
- 13. Cystoscopy
- 14. Post-op Remarks
- Locate Sacral Promontory
- Clear Sacral Promontory
- Lateral - Right
- Anterior
- Lateral Stalks - Right
- Lateral - Left
- Finish Posterior
- Review Dissection
- Approach
- Place Sutures
- Extracorporeal Tying
- Approach
- Inject Local Anesthetic
- Excise Epithelium
- Tag Apex
- Bring Together Levator Muscles
- Rebuild Perineal Body
- Close Epithelium
- Rectal Exam
