Perineal Rectopexy

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The earliest versions of this procedure were described by Lockhart-Mummery in 1910. Packing the retrorectal space with gauze was found to have a prohibitively high recurrence rate. Inserting a Mersilene mesh high in the retrorectal space and suturing the edges to the sides of the rectum modified the technique to improve the recurrence rate.24 Mobilization of the rectum and placement of mesh was performed through a posterior perineal approach, occasionally removing the coccyx to improve exposure (Fig. 20.6). In a series of 22 women with a mean age of 75 years undergoing this procedure, there were no deaths or significant morbidity and only one recurrence.

Figure 20.6. Perineal rectopexy. Through a posterior perineal incision, the rectum is widely mobilized. A patch of Mersilene mesh is sewn to the sacrum. The sides of the rectum will then be sutured to its edges. From Karulf RE, Madoff RD, Goldberg SM. Rectal prolapse. Curr Probl Surg 2001; 38:771-832, with permission from Elsevier.

Figure 20.6. Perineal rectopexy. Through a posterior perineal incision, the rectum is widely mobilized. A patch of Mersilene mesh is sewn to the sacrum. The sides of the rectum will then be sutured to its edges. From Karulf RE, Madoff RD, Goldberg SM. Rectal prolapse. Curr Probl Surg 2001; 38:771-832, with permission from Elsevier.

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