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.
The Altemeier Procedure carries higher recurrence rates (20-25%) than abdominal rectopexy but is safe and effective for high anaesthetic-risk patients. It can be combined with levatoroplasty to improve continence.
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, Lux Hospitals, Hyderabad
Altemeier Procedure (Perineal Rectosigmoidectomy) Cost in Hyderabad
The cost of Altemeier procedure (perineal rectosigmoidectomy) in Hyderabad depends on the extent of rectal prolapse, complexity of the condition, patient’s overall health status, investigations required, and the care needed before and after surgery.
For patients with full-thickness rectal prolapse who are not suitable candidates for abdominal surgery, the approximate cost of Altemeier procedure ranges between ₹90,000 and ₹1,80,000.
| Procedure | Approximate Cost Range |
|---|---|
| Altemeier (Perineal Rectosigmoidectomy) | ₹90,000 – ₹1,80,000 |
The final cost may vary depending on your individual condition, findings during evaluation, and whether any additional procedures are required.
Factors That Influence Altemeier Procedure Cost
The overall cost may depend on:
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Severity and extent of rectal prolapse: The degree of prolapse, length of the affected rectal segment, and associated bowel conditions may influence treatment planning and surgical complexity.
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Pre-operative evaluation: Required investigations, clinical examination, imaging, and medical assessments before surgery may affect the overall cost.
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Additional procedures: If procedures such as bowel repair, management of associated pelvic floor conditions, or other prolapse-related treatments are required, the cost may vary.
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Hospital stay and post-operative care: The duration of admission, medicines, bowel care, and follow-up requirements may influence the final estimate.
Is Altemeier Procedure Covered by Insurance?
Altemeier procedure may be covered by health insurance when it is performed for a medically necessary condition. Coverage depends on your insurance policy, inclusions, and approval process.
Our insurance support team can assist you with checking your policy coverage, required documentation, cashless approval process, and insurance-related queries before the procedure.
- Checking your policy coverage
- Cashless approval process
- Required documentation
- Insurance-related queries before the procedure
Dr. Samhitha Reddy
Consultant Proctologist & Laparoscopic Surgeon
During consultation, Dr. Samhitha Reddy, Proctologist and Colorectal Specialist in Hyderabad, will evaluate your symptoms, medical history, and investigation reports to determine whether Altemeier procedure is suitable for you. She will explain the procedure, expected outcomes, and guide you regarding the estimated cost based on your individual condition and treatment requirements.
Common Questions
Frequently Asked Questions
Not sure which treatment is right for you?
Book a consultation with Dr. Samhitha Reddy and get a personalised treatment plan.