Ripstein procedure. Lahey Clinic experience: 1963-1985

P. L. Roberts, D. J. Schoetz Jr, J. A. Coller and M. C. Veidenheimer
Department of Colon and Rectal Surgery, Lahey Clinic Medical Center, Burlington, MA 01805.

We reviewed our 22-year experience with 135 Ripstein procedures for rectal prolapse in 118 women and 17 men. Follow-up ranged from one to 256 months (median, 41 months). Five patients were unavailable for follow-up. There was one perioperative death (0.7%). Complications included hemorrhage from presacral veins in 11 patients (8.1%), recurrent prolapse in 13 patients (9.6%), and stricture at the site of the sling in three patients (2.2%). Specific intraoperative technical factors could be related to recurrent prolapse in four patients (30.8%). Attention to technical details is mandatory to minimize immediate and long-term complications. Patients should be prepared for anterior resection, since a sling procedure may be inadvisable at the time of exploration. Resection may be the preferred operation for men, who have a high rate of recurrent prolapse with the Ripstein procedure.