Laparoscopic implementation of the Altemeier procedure for recurrent rectal prolapse. Technical note

Area of Science:

• Colorectal Surgery
• Minimally Invasive Surgery
• Surgical Innovation

Background:

• Rectal prolapse management involves various perineal and abdominal surgical options.
• Perineal approaches offer reduced invasivity and hospital stay compared to transabdominal methods.
• A clear distinction existed between perineal (emergency) and transabdominal (elective) surgical approaches.

Purpose of the Study:

• To report the first case of a combined laparoscopic-perineal approach for complicated rectal prolapse recurrence.
• To evaluate the feasibility, safety, and outcomes of this novel combined surgical technique.

Main Methods:

• A 37-year-old female with psychiatric disease and a second recurrence of complicated rectal prolapse was treated.
• The patient underwent a third Altemeier procedure, augmented with laparoscopic control.
• The procedure combined perineal access with laparoscopic assistance.

Main Results:

• The patient experienced a prompt recovery without complications.
• No recurrence of rectal prolapse was observed during the 24-month follow-up period.
• The combined approach demonstrated technical feasibility and optimal outcomes.

Conclusions:

• This laparoscopic-assisted perineal approach represents a significant advancement for treating recurrent rectal prolapse.
• It enhances the effectiveness, safety, and results of the conventional Altemeier procedure.
• The technique combines the simplicity of perineal surgery with the benefits of abdominal control, minimizing invasivity and procedure duration.