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  • Title
  • 1. Introduction
  • 2. Patient Preparation
  • 3. Full-Thickness Rectal Dissection to the Mesentery on the Inside
  • 4. Evert Rectum to See Entire Rectal Edge
  • 5. Open Pouch of Douglas to Enter Abdominal Cavity
  • 6. Inspect Sigmoid Colon and Determine Level of Resection
  • 7. Posterior Levatorplasty
  • 8. Close Pouch of Douglas
  • 9. Transection
  • 10. Complete Anastomosis
  • 11. Inject Marcaine for Pudendal Nerve Block
  • 12. Examination of Specimen
  • 13. Post-op Remarks

Altemeier Perineal Proctosigmoidectomy for Rectal Prolapse

20782 views

Madison S. McCarthy; Charlotte M. Rajasingh, MD; Brooke Gurland, MD, FACS
Stanford University School of Medicine

General Surgery

Procedure Outline

Table of Contents

  1. 1. Introduction
    1. 2. Patient Preparation
      1. 3. Full-Thickness Rectal Dissection to the Mesentery on the Inside
        1. 4. Evert Rectum to See Entire Rectal Edge
          1. 5. Open Pouch of Douglas to Enter Abdominal Cavity
            1. 6. Inspect Sigmoid Colon and Determine Level of Resection
              1. 7. Posterior Levatorplasty
                1. 8. Close Pouch of Douglas
                  1. 9. Transection
                    1. 10. Complete Anastomosis
                      1. 11. Inject Marcaine for Pudendal Nerve Block
                        1. 12. Examination of Specimen
                          1. 13. Post-op Remarks

                            1. Introduction

                            2. Patient Preparation

                            1. Patient Positioning
                            2. Preoperative Exam and Delivery of Prolapse
                            3. Exposure with Retractor
                            4. Examine Anatomy and Score Dissection Line Around Rectum
                            5. Inject Local Anesthetic Along Score Line for Hemostasis

                            3. Full-Thickness Rectal Dissection to the Mesentery on the Inside

                            4. Evert Rectum to See Entire Rectal Edge

                            1. Make Windows into Mesentery and Divide with LigaSure to Deliver More Rectum

                            5. Open Pouch of Douglas to Enter Abdominal Cavity

                            6. Inspect Sigmoid Colon and Determine Level of Resection

                            7. Posterior Levatorplasty

                            8. Close Pouch of Douglas

                            9. Transection

                            10. Complete Anastomosis

                            11. Inject Marcaine for Pudendal Nerve Block

                            12. Examination of Specimen

                            13. Post-op Remarks

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                            Authors

                            Filmed At:

                            Stanford University Medical Center

                            Article Information

                            Publication Date
                            Article ID356
                            Production ID0356
                            Volume2022
                            Issue356
                            DOI
                            https://doi.org/10.24296/jomi/356