Ripstein Procedure: Operative Procedure and Result

Abstract

Operative Procedur : The rectum is mobilized from the hollow of the sacrum. The rectum is then fixed to hollow of the sacrum by suturing a T-shaped sling of Teflon mesh. The edges of the sling are fixed to the circumference of the bowel and the anterior limb is sewn on the anterior rectal wall. No attempt is made to repair the pelvic floor.
Result : Fourteen patients with rectal prolapse were undergone with Ripstein pro-cedure. They were five males and nine females.
The Period of follow-up time ranged from 2 months to 16 years. There has been no recurrence. However, in one patient, anterior resection was needed after this procedure when volvulus was developed. In a female patient, the removal of Teflon-sling and anterior resection were performed because of severe constipation.
In other cases of 60 and 76 year-old female patients, rectal carcinoma and urinary bladder carcinoma were developed at postoperative 9 and 4 years respectively, but the lesions were excised, and patients have been asymptomatic since the second operation. We believe that this procedure is simple and safe with a few recurrences of disease, and it can be easily applied in elderly, poor-risk patients