Altemeier Procedure (Perineal Rectosigmoidectomy)
A full-thickness perineal resection of the prolapsed rectal segment - definitive treatment for full-thickness rectal prolapse in elderly or high-risk patients, performed through the perineum with no abdominal incisions.
What is Altemeier Procedure (Perineal Rectosigmoidectomy)?
The Altemeier Procedure (Perineal Proctosigmoidectomy) resects the entire prolapsed rectal segment (and sometimes part of the sigmoid colon) and creates an anastomosis - all performed through the perineum without any abdominal incision. Unlike the Delorme Procedure which preserves the bowel, the Altemeier Procedure resects the redundant tissue definitively. Dr. Samhitha Reddy performs the Altemeier Procedure at Lux Hospitals, Hyderabad for full-thickness rectal prolapse in elderly or frail patients where laparoscopic rectopexy carries excessive risk. As part of the comprehensive rectal prolapse treatment in Hyderabad programme, it achieves complete resection of the redundant segment with no abdominal wounds - an important safety advantage for this patient group.
How the Procedure Works
Prolapse Eversion
The full prolapse is completely everted under spinal or general anaesthesia to expose the full extent of the prolapsed segment.
Peritoneal Entry
The peritoneum of the pouch of Douglas on the anterior surface of the prolapsed rectum is incised - entering the peritoneal cavity through the perineum.
Mesorectal Dissection
The mesorectum and mesosigmoid are divided progressively until sufficient redundant bowel has been freed for resection at the appropriate level.
Bowel Resection & Anastomosis
The redundant rectal and sigmoid segment is transected. A hand-sewn anastomosis is created between the healthy proximal bowel and the anal stump at the level of the dentate line.
Levatoroplasty (Optional)
The levator ani muscles are plicated posteriorly - narrowing the pelvic floor and improving continence outcomes.
Outcomes
Who Needs This Treatment?
- →Resects the entire redundant prolapsed segment - definitive tissue removal
- →No abdominal incisions - entirely perineal approach
- →Safe for elderly and medically frail patients who cannot tolerate abdominal surgery
- →Can be combined with levatoroplasty to improve functional outcomes
- →Short hospital stay - 1-2 days
- →Available at Lux Hospitals, Hyderabad as part of the complete rectal prolapse surgical programme
The Altemeier Procedure is a bold, definitive perineal approach - it resects everything that needs to come out and rebuilds a functioning anastomosis, all without opening the abdomen. For frail elderly patients with large prolapse, it provides excellent results with very tolerable recovery.
— - Dr. Samhitha Reddy, Consultant Proctologist & Laparoscopic Surgeon
Common Questions
Frequently Asked
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