Name of the Procedure:

Proctoplasty
Common Name(s): Rectal Prolapse Repair
Medical Term: Proctoplasty for Prolapse of Mucous Membrane

Summary

Proctoplasty is a surgical procedure aimed at correcting a prolapsed mucous membrane of the rectum. The surgery involves repairing and reinforcing the rectal structures to alleviate symptoms and prevent further prolapse.

Purpose

Proctoplasty addresses rectal mucosal prolapse, which can cause discomfort, pain, and difficulty with bowel movements. The goal is to restore normal rectal function and alleviate symptoms by repairing and securing the prolapsed tissue.

Indications

• Visible prolapse of the rectal mucous membrane, particularly during bowel movements
• Symptoms such as pain, bleeding, or mucus discharge from the rectum
• Chronic constipation or incomplete bowel movements
• Incontinence or difficulty controlling bowel movements

Preparation

• Patients might need to fast for 12 hours before the procedure.
• Bowel preparation, such as enemas or laxatives, may be required to clear the bowels.
• Patients should inform their doctor about any medications they are taking; some may need to be adjusted or paused.
• Preoperative evaluations may include a physical examination, imaging studies like a colonoscopy, and blood tests.

Procedure Description

1. Anesthesia: The patient is typically given general anesthesia, although local anesthesia with sedation may sometimes be used.
2. Positioning: The patient is positioned to allow optimal access to the rectal area.
3. Access: A small incision is made around the rectum to expose the prolapsed mucous membrane.
4. Repair: The prolapsed tissue is carefully positioned back into its normal place. The surgeon may use sutures or other techniques to reinforce and secure the rectal structure.
5. Closure: Incisions are closed, and the area is cleaned and dressed.

Duration

The procedure typically takes about 1-2 hours, depending on the complexity of the prolapse and the surgical technique used.

Setting

Proctoplasty is usually performed in a hospital or outpatient surgical center equipped with the necessary surgical facilities.

Personnel

• Surgeon: Specializes in colorectal and proctologic surgery
• Anesthesiologist: Manages anesthesia and monitors the patient’s vital signs
• Nurses/Operating Room Staff: Assist with the procedure and patient care

Risks and Complications

• Common Risks: Bleeding, infection, pain, and swelling at the surgical site
• Rare Risks: Bowel perforation, deep vein thrombosis, and adverse reactions to anesthesia
• Complications: Recurrence of prolapse, difficulty with bowel movements, and in rare cases, complications related to anesthesia

Benefits

• Relief from symptoms such as pain, bleeding, and discomfort
• Improved bowel function and control
• Prevention of further prolapse and associated complications
• Patients generally notice symptom improvement shortly after recovery.

Recovery

• Post-procedure care: Pain management, antibiotics, and stool softeners may be prescribed.
• Follow-up appointments: Necessary to monitor healing and address any concerns.
• Activity restrictions: Avoid heavy lifting, strenuous activities, and certain types of physical exertion for several weeks.
• Expected recovery time: Typically 4-6 weeks, with gradual resumption of normal activities.

Alternatives

• Non-surgical treatments: Dietary modifications, physical therapy, and medications to manage symptoms
• Other surgical options: Less invasive procedures or different techniques, such as rectopexy
• Pros and Cons: Non-surgical options might provide temporary relief but may not address the underlying cause.

Patient Experience

• During the procedure: Patients are under anesthesia and should not feel pain.
• After the procedure: Pain and discomfort can be managed with medications. Patients may experience some mild discomfort and restrictions in bowel movements initially.
• Pain management: Prescribed pain relievers and methods to manage post-operative pain and ensure comfort are typically discussed beforehand.

By understanding the procedure, preparation, and recovery, patients can better prepare and make informed decisions regarding their healthcare.