Delorme Procedure

Abstract

Indications • Partial thickness, mucosal rectal prolapse • Recurrent full-thickness rectal prolapse, especially in high-risk patients Essential Steps 1. Rectal exam. 2. Lithotomy/prone jackknife position. 3. Grasp the mucosa of the rectum and prolapse mucosa and submucosa to fullest extent. 4. Score rectal mucosa approximately 2 cm cephalad to dentate line. 5. Circumferentially dissect mucosa proximally, leaving the terminal 2 cm in situ. 6. Place plicating sutures in muscular wall of the rectum. 7. Excise redundant mucosa and reapproximate it. Complications • Recurrence • Urinary retention • Bleeding • Anal stenosis • Injury to rectovaginal septum causing fistula Template Operative Dictation Preoperative Diagnosis Partial thickness, mucosal rectal prolapse/others Procedure Delorme procedure Postoperative Diagnosis Same Indications This ___-year-old male/female with partial thickness, mucosal rectal prolapse/others Description of Procedure The patient was brought to the operating room. Time-outs were performed using both preinduction and pre-incision safety checklists to verify correct patient, procedure, site, and additional critical information prior to beginning the procedure. After the induction of general/spinal anesthesia/sedation, the patient was positioned in the prone jackknife/ lithotomy position. The perineum was prepped and draped in the usual sterile fashion. A digital rectal exam was performed and revealed ______. Examination of the anal canal revealed redundant rectal mucosa and submucosa in all four quadrants. There were/ were not any other anorectal abnormalities.