Perineal Surgical Repair for Rectal Prolapse

Delorme's procedure is a perineal (through the anus) surgical technique used to treat full-thickness rectal prolapse. It involves excising the prolapsed mucosa, placating (folding and suturing) the underlying muscular layer, and then reapproximating the mucosa. This procedure is particularly suitable for elderly or frail patients who are not candidates for abdominal surgery.

Dr. Surendra Pal Jakhar has extensive experience in performing Delorme's procedure for patients with rectal prolapse. This technique offers excellent results with low morbidity, short hospital stay, and good functional outcomes, making it an ideal choice for high-risk patients.

Indications for Delorme's Procedure

• Full-Thickness Rectal Prolapse: Complete protrusion of the rectal wall through the anus.
• Elderly Patients: Patients with significant comorbidities who are unfit for abdominal surgery.
• High Surgical Risk: Patients with cardiac, pulmonary, or other medical conditions that increase surgical risk.
• Recurrent Prolapse: Patients who have had previous abdominal procedures for prolapse.
• Patient Preference: Individuals who prefer a perineal approach over abdominal surgery.
• Partial or Mucosal Prolapse: Selected cases of mucosal prolapse.

Surgical Procedure Details

• Preoperative Preparation: Mechanical bowel preparation and prophylactic antibiotics. Thorough evaluation of the patient's overall health and surgical risk.
• Positioning: Patient is placed in the lithotomy or jackknife position under general or regional anesthesia.
• Prolapse Reduction: The prolapsed rectum is gently reduced and held with traction sutures.
• Mucosal Excision: A circumferential incision is made at the dentate line, and the mucosa is dissected from the underlying muscular layer.
• Muscular Plication: The exposed muscular wall is plicated (plicated) using interrupted sutures to narrow the lumen and shorten the rectum.
• Mucosal Reapproximation: The mucosa is then sutured back to the dentate line, completing the repair.
• Completion: A drain may be placed, and the procedure is completed without an abdominal incision.

Advantages of Delorme's Procedure

• No abdominal incision – reduced pain and faster recovery
• Lower morbidity compared to abdominal procedures
• Shorter hospital stay (typically 1-3 days)
• No need for mesh or foreign material
• Lower risk of major complications in elderly patients
• Good functional outcomes with improvement in continence
• Safe alternative for high-risk surgical patients

Post-Operative Care and Recovery

• Hospital stay typically 1-3 days
• Pain management with oral analgesics
• Dietary modifications – starting with clear liquids and progressing to a high-fiber diet
• Stool softeners to prevent constipation and straining
• Avoidance of heavy lifting and strenuous activities for 4-6 weeks
• Regular follow-up to monitor for recurrence and assess bowel function
• Gradual return to normal activities as tolerated

Why Choose Dr. Surendra Pal Jakhar?

Dr. Surendra Pal Jakhar is a highly experienced colorectal surgeon with specialized expertise in perineal procedures for rectal prolapse, including Delorme's procedure. His meticulous surgical technique, comprehensive preoperative evaluation, and compassionate patient care ensure the best possible outcomes for his patients. Dr. Jakhar works closely with a multidisciplinary team to provide individualized care tailored to each patient's condition and overall health status.

Schedule a consultation today to discuss your rectal prolapse and explore whether Delorme's procedure is the right treatment option for you.