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Transanal suture sacro-rectopexy for prolapse & intussusceptions of rectum - Page 2

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Transanal suture sacro-rectopexy for prolapse & intussusceptions of rectum
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The incidence of rectal prolapsed related to male/ female ratio and age is different in various part of world. Familial Collagen structural disorder and different type of bowel habits may be deciding factors. Transanal procedures are present since last 60 years in form of recto-sigmoidectomy in which whole redundant part of sigmoid and rectum is excised to correct prolapsed rectum. (23) Normally the sigmoid shape is adopted due to redundant lax pelvic colon. Removal of part of sigmoid and rectum corrects prolapse in 85 to 60 % cases. (24-25) There is no fixation of rectum which results poor repair and more complications.

In sophisticated modern procedure for recto-sigmoidectomy is done in piece meal- STARR procedure. Prolapse of rectum of any stage is managed by STARR procedure. The complications and cost of procedure is very high and recurrence rate reported is matching to the recto-sigmoidectomy.( 26-28  ) STAAR resects redundant bowel but does not fix it.

Transanal fixation of rectum to the sacrum after opening rectum is similar procedure. The opening and suturing of mesorectum was done and then rectal wall was sutured. Fixation of meso rectum to the sacrum will depend on development of fibrosis and fixation of the rectum to sacrum. It is likely to form haematoma and infection. (29) Dissection around the rectum is advocated before fixing the rectum to the sacrum in open abdominal or laparoscopy procedures. By dissecting around the rectum, neuro receptors situated in the pelvic wall and sacral cavity are disturbed and constipation is worsened, who had preoperative and developed in additional cases.

Transanal suture sacro rectopexy requires no dissection, only suturing is performed which is very simple. There is no anastomosis which may cause strictures infection or hematoma. No costly instruments or disposables are necessary. Learning curve is negligible.


Transanal suture sacro rectopexy is very simple but effective procedure. Nearly no complications are reported. There is no increase in severity or incidence in constipation. The series need larger number and longer follow up. Confirmation of effectiveness of the procedure to repair prolapse of rectum require extensive and wide utilization.


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1 2 4

Fig No 1 Procedemcia Rectum

Fig. No. 2 –A Closed proctoscope

Fig No2- B  Proctoscope opened

Fig. No. 2  Proctoscope placed at level S3. Deaver’s retractor in place to press rectum to the sacrum

5 6 7 8

Fig. No. 3   Trans anal suture rectopexy Two suture at level of S 3 are seen.

Fig. No. 4  Rectocle

Fig. No.5 Rectocle finger in the rectum

Fig. No. 6 Rectocle Repair with levateroplasty