OPERATION: Altemeier's Procedure (Perineal Rectosigmoidectomy)
ANAESTHETIC: General anaesthesia
ANTIBIOTICS: Gentamicin and Metronidazole. Urinary catheter.
POSITION: Left lateral.
FINDINGS: Full-thickness rectal prolapse [size] cm.
PROCEDURE:
Prolapse delivered.
Mucosa marked 1cm above dentate line circumferentially.
Circumferential full-thickness incision through rectal wall following marked line.
Peritoneum opened anteriorly into pouch of Douglas.
Anterior structures mobilised off rectum.
Mesorectum divided with Ligasure.
Rectum divided at point of convenience to achieve tension-free anastomosis.
Collatamp placed behind anastomosis at 6 o'clock.
Colorectal anastomosis performed with interrupted 3-0 PDS.
POST-OPERATIVE INSTRUCTIONS:
Eat and drink as tolerated.
Movicol 1 sachet twice daily to continue.
Trial without catheter the following morning.
Home the following day if well. Telephone follow-up in 3 months.