anterior rectal fold

Suitable for most cases of rectal full-thickness prolapse. The purpose of this procedure is to improve the rectal bladder (or rectal uterus) lacuna, tighten the levator ani muscles and fold to shorten the anterior wall of the rectum, which can more completely repair anatomical defects. Treatment of diseases: rectal prolapse Indication Suitable for most patients with full rectal prolapse. Preoperative preparation 1. Low slag diet 1 day before surgery. 2. Enema with soapy water 2 to 3 hours before surgery, no need for intestinal antibiotic preparation. 3. Preoperative routine indwelling catheter. Surgical procedure 1. Position: supine position. 2. Incision: From the pubic symphysis to the 2cm on the umbilicus for the left median side incision, separate the rectus abdominis muscle, cut the cone muscle, cut the peritoneum, and enter the abdominal cavity. 3. Reveal the pelvic floor: change the body position to the head low foot high position (inclination 10 ° ~ 20 ° is appropriate). The small intestine was pushed up to the abdomen with a warm saline gauze pad to reveal the rectal bladder (or rectal uterus). The rectum is lifted and tightened, and the peritoneum is cut along the anterior wall of the rectum near the recess of the bladder [Fig. 1 (1)]. The connective tissue of the retroperitoneum is separated, and the ureters are exposed and protected to avoid damage. The pre-rectal adipose tissue is separated down to the mucosa, revealing the edge of the levator fascia. 4. Tightening the levator ani muscle: Find the anterior edge of the levator fascia on both sides, use the medium thread to interrupt or loosen the levator ani muscles on both sides to shorten it by 1-2 cm to enhance its support for the rectum. Role and strengthen the role of the anal sphincter. If the levator ani muscle is very thin, or if it is not found because of adhesion, it can be sewed. 5. Tightening the levator ani muscle: Find the anterior edge of the levator fascia on both sides, and use the medium thread to interrupt or loosen the levator ani muscles on both sides to shorten it by 1~2cm to enhance its support for the rectum. Role and strengthen the role of the anal sphincter. If the levator ani muscle is very thin, or if it is not found because of adhesion, it can be sewed. Stitching: After folding and raising the anterior rectal wall, the incision of the incision of the anterior rectal wall of the rectum is sutured with a silk thread at the lowest position of the anterior wall of the rectum to improve the rectal bladder recession. The peritoneal incision margins on both sides of the rectum were sutured. Finally, the abdominal wall incision was sutured.

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