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  • Title
  • 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

Article type:Descriptions of Clinical and Surgical Procedures

Laparoscopic Suture Rectopexy with Culdoplasty, Vaginal Wall Repair, and Perineorrhaphy for Rectal Prolapse

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Marcus V. Ortega, MD1,2; Emily C. Von Bargen, DO1,2*; Liliana G. Bordeianou, MD1,3*

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

General SurgeryObstetrics & GynecologyMultidisciplinary Surgery

Manuscript Format: Full Text

Procedure Outline

Table of Contents

  1. 1. Introduction
    1. 2. Surgical Approach and Laparoscopic Access
      1. 3. Reduce Bowel out of Pelvis
        1. 4. Preparation of Sacral Promontory for Sutures
          1. 5. Rectum Mobilization
            1. 6. Suture
              1. 7. Review Progress
                1. 8. Approach to Culdoplasty
                  1. 9. Culdoplasty
                    1. 10. Reconstruct Pouch of Douglas
                      1. 11. Finish Closing Peritoneum
                        1. 12. Perineorrhaphy and Levator Plication
                          1. 13. Cystoscopy
                            1. 14. Post-op Remarks

                              1. Introduction

                              2. Surgical Approach and Laparoscopic Access

                              3. Reduce Bowel out of Pelvis

                              4. Preparation of Sacral Promontory for Sutures

                              1. Locate Sacral Promontory
                              2. Clear Sacral Promontory

                              5. Rectum Mobilization

                              1. Lateral - Right
                              2. Anterior
                              3. Lateral Stalks - Right
                              4. Lateral - Left
                              5. Finish Posterior
                              6. Review Dissection

                              6. Suture

                              1. Approach
                              2. Place Sutures
                              3. Extracorporeal Tying

                              7. Review Progress

                              8. Approach to Culdoplasty

                              9. Culdoplasty

                              10. Reconstruct Pouch of Douglas

                              11. Finish Closing Peritoneum

                              12. Perineorrhaphy and Levator Plication

                              1. Approach
                              2. Inject Local Anesthetic
                              3. Excise Epithelium
                              4. Tag Apex
                              5. Bring Together Levator Muscles
                              6. Rebuild Perineal Body
                              7. Close Epithelium
                              8. Rectal Exam

                              13. Cystoscopy

                              14. Post-op Remarks

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                              Authors

                              Filmed At:

                              Massachusetts General Hospital

                              Article Information

                              Publication Date
                              Article ID272
                              Production ID0272
                              Volume2022
                              Issue272
                              DOI
                              https://doi.org/10.24296/jomi/272