Altemeier Perineal Proctosigmoidectomy for Rectal Prolapse
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Procedure Outline
Table of Contents
- 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
- Patient Positioning
- Preoperative Exam and Delivery of Prolapse
- Exposure with Retractor
- Examine Anatomy and Score Dissection Line Around Rectum
- Inject Local Anesthetic Along Score Line for Hemostasis
- Make Windows into Mesentery and Divide with LigaSure to Deliver More Rectum
