Transabdominal posterior proctopexy using an inverted T of synthetic material

J. R. Hilsabeck

In the management of complete rectal prolapse, the data indicate that transabdominal mobilization of the rectum with secure fixation to the sacrum has no higher rate of recurrence than rectosigmoidectomy by any route, and has less risk than anterior resection. Of 17 patients with complete rectal prolapse who were operated on during a five-year period, 16 were managed by the above method; two by the Orr-Loygue method using polypropylene mesh: and 14 by positioning an inverted T-shaped piece of polypropylene posteriorly to anchor the mobilized rectum to the sacral promontory. There were no surgical deaths, rejections of polypropylene, or complete recurrences in two to 56 months of follow-up. One patient experienced a mucosal recurrence only. These 16 cases further support the practice of abdominal proctopexy without resection. The polypropylene T procedure overcomes a potential disadvantage of the Orr-Loygue procedure.