Presacral Rectopexy
Objective
In case of:
• Rectal prolapse
• Mobilizing the rectum
within the abdomen (and pelvis)
• Fixing it to the
presacral fascia and periosteum
• Encircling band of
material such as Teflon, Marlex or Mersilene mesh
Position
Supine.
Anesthesia
General.
Procedure
1. Vertical or transverse
incision.
2. Rectum is dissected from
its supporting tissue attachments.
3. A mesh of Marlex (or
Mersilene, Teflon, etc) is sutured to the presacral periosteum, taking care to
avoid the local venous plexus.
4. Mesh is placed around the
bowel to anchor it to the sacrum without restricting the rectum too tightly.
5. Abdomen is closed in
layers.
Instruments
• General set
• Deep instrument set
• Gastrointestinal set
• Harrington’s retractor
(Fig. 9.26)
• Self-retaining retractor
(e.g. Balfour) (Fig. 8.9B)
• Mesh or banding
materials
• Hemoclip appliers.
Any questions be sent to drmmkapur@gmail.com
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