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Colorectal Channel
Rectal Prolapse Repair Following a Posterior Sagittal Anorectoplasty
Chapter 1 of 4 · Case-Based Learning
Clinical context
Introduction and Clinical Context
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Host summaries · secondary, not cited in answers
Educational content from recorded physician discussions — not medical advice. Talk to your (or your child's) care team about your situation.
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What the experts said
The anoplasty location should be checked with an electrical stimulator to confirm it is well located with circumferential contractions.
Full thickness rectum is incised off of the skin edge while preserving the sphincter muscle.
Leaving the right side of the anoplasty untouched reduces the risk of a postoperative stricture.
The rectum is mobilized out until there is slight tension, and the intended cut line will comfortably reach the anal skin.
Extra stitches placed into the redundancy help straighten out the rectal tissue prior to incising it.
The Lone Star retractor is very helpful to set up the anoplasty.
The anoplasty is performed by taking a bite of anal skin to full thickness rectal wall.
Dividing the upper and lower quadrants of the left-sided prolapse creates two triangles.
All sutures are tied under slight tension, so that once cut, the anoplasty retracts back nicely.
Rectal prolapse is a very common problem following repair of an anorectal malformation.
Rectal prolapse can cause mucous production and bleeding.
Rectal prolapse can interfere with the patient's ability to close the anus and thereby affect their bowel control.