Modified perineal stapled rectal resection with Contour Transtar for full-thickness rectal prolapse

We report a modified technique of perineal proctectomy using a new reloadable curved cutter stapler, the Contour Transtar (Ethicon Endo-Surgery), to treat full-thickness external rectal prolapse.

Between May and July 2008 three female patients were treated. All had a full-thickness external rectal prolapse up to 10 cm in length. The prolapse was initially divided by a linear cutter in anterior and posterior flaps, and resection of the prolapse was performed with a Contour Transtar stapler.

There was no mortality or early or late morbidity. Follow-up was 2-4 months. All patients had a bowel movement within 3 days of the operation, oral feeding started immediately and the hospital stay was 5 days in all cases. All patients reported an improvement of constipation and continence.

Our procedure may be indicated for full-thickness prolapse with a rectal protrusion up to 10 cm, as it allows a simple resection without any mobilization or dissection of the rectum. The technique is safe, easier and faster to perform than conventional perineal rectosigmoidectomy.