LAPAROSCOPIC-ASSISTED ABDOMINOPERINEAL PROCTOSIGMOIDECTOMY FOR RECTALPROLAPSE - A NEW TECHNIQUE

The inability to completely mobilize the redundant colon in perineal r ectosigmoidectomy (Altemeier's procedure) for full-thickness rectal pr olapse is a main contributor to the recurrence rate associated with th e procedure. However, the presence of a redundant sigmoid after the Ri pstein procedure or other rectal sling operations is the main cause of the high rate of postoperative constipation and stool impaction. Low anterior resection as the definitive treatment is associated with the higher morbidity of laparotomy and the risk of anastomotic leak. We de scribe a laparoscopic-assisted surgical approach which combines the be nefits of completely resecting the redundant sigmoid colon as well as the performance of extraperitoneal anastomosis at the level of the anu s.