Thiersh procedure Rectum

Thiersch Procedure

Objective

In case of rectal prolapse:

•   A circumferential device or mesh around rectum to restrict downward movement of rectum.

Position

Supine (Lithotomy) or jacknife.

Anesthesia

General.

Procedure

1.  Two incision, 1 cm each are made opposite one another around the anus.

2.  Curved hemostat is passed deep in the perianal tissues external to the sphincter (avoiding the vagina), encircling the sphincter, and exiting the opposite incision.

3.  The prosthetic material is passed through the tunnel created by the clamp.

4.  Repeated for the other side (prosthesis completely encircles the anal canal).

5.  The prosthetic ends are sutured.

6.  The wounds are closed.

Instruments

•   Rectal set

•   Rectal retractors, including Sims, Hill-Fergusson and Sawyer (Fig. 9.17)

•   Prosthesis.

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