Abstract:

The aim of this study is to describe the feasibility, safety, and efficiency of LigaSure™ Vessel Sealing System (LSVSS) in Altemeier’s procedure for full-thickness rectal prolapse in a geriatric group of octogenarians and older. To the best of our knowledge, this is the first time a study on this procedure looks specifically at a very old patient group and LigaSure. A review of the literature was conducted on Pubmed Database. From April 2008 to October 2013, seven female patients (median age, 89 years) underwent Altemeier’s procedure for prolapse using the LSVSS. Preoperative, intraoperative, and postoperative data were collected and analyzed for all patients. Five out of seven patients were ASA class III and had previous history of pelvic surgery. All had preexisting medical conditions other than the full-thickness rectal prolapse. Stapled anastomoses were performed in 6/7 cases with a circular stapling device. The median surgical time was 74 min. and intraoperative blood loss was minimal for all 7 patients. The median length of the resected specimen was 9 cm. There was no surgery-related mortality or recurrence. All patients had at least a 2-year follow-up. The use of the LSVSS in Altemeier’s procedure is feasible, safe, and time-saving.

Authors:

Sandra Maria Moreira Paim, MD, FBCS, FBSCRS, Researcher, Colon and Rectal Surgeon, Department of Colon and Rectal Surgery, St. Mark’s Hospital, Salt Lake City, Utah, Eric Changchien, MD, Colon and Rectal Surgeon, Department of Colon and Rectal Surgery, St. Mark’s Hospital, Salt Lake City, Utah, John A Griffin, MD, FACS, FASCRS, Chair and Colon and Rectal Surgeon, Department of Colon and Rectal Surgery, St. Mark’s Hospital, Salt Lake City, Utah, Program Director, Colon and Rectal Fellowship , St. Mark’s Healthcare Foundation Program , Salt Lake City, Utah

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