Rectal prolapse. An update on the rectal sling procedure

The rectal sling procedure has been used successfully in treating rectal prolapse for over three decades. Recurrences are rare; however, difficulties have developed from excessive reaction to some prosthetic slings and the failure of others to allow tissue ingrowth. Gore-Tex is presented as an ideal material for correction of the rectal sling because of its inert properties and porous structure which allows tissue incorporation. The problem of postoperative fecal impaction created by pulling the sling too tight has also been circumvented by placing the sling posteriorly, leaving the anterior rectal wall free to distend. The Ripstein procedure is described in detail, and a series of 23 patients is presented who have had successful rectal prolapse repair using the new rectal sling procedure. There have been no recurrences and minimal morbidity in these cases.