✦ PERINEAL RESECTION FOR PROLAPSE

Altemeier Procedure

Q: How is Altemeier different from Delorme?

Delorme strips and folds the lining without removing bowel, while Altemeier resects the redundant prolapsed segment entirely. Altemeier is preferred for longer prolapses where simple folding is not enough.

Q: Will my prolapse come back?

Recurrence rates are slightly higher than abdominal rectopexy. Good bowel habits, avoiding straining, and pelvic floor exercises support long-term results.

Q: Is the surgery painful?

Pain is usually moderate and managed well with simple analgesics and sitz baths. Most patients are comfortable within a few days.

Q: How quickly can I return to normal activities?

Most patients return to routine in 1–2 weeks. Heavy lifting and strenuous activity are avoided for 4–6 weeks for complete healing of the bowel join.

Perineal resection for rectal prolapse — the prolapsed segment is removed through the anus and the bowel is reconnected — ideal for longer prolapses in elderly or frail patients.

75–120 min PROCEDURE

2–3 Days HOSPITAL STAY

>85% SUCCESS RATE

1–2 Weeks RETURN TO ROUTINE

What is Altemeier Procedure?

The Altemeier Procedure (perineal proctosigmoidectomy) is a perineal operation for full-thickness rectal prolapse in which the prolapsed segment is removed entirely through the anus and the healthy bowel ends are reconnected. Like the Delorme, it avoids abdominal surgery and is well-suited for elderly or frail patients, but is particularly effective for longer prolapses where Delorme alone may not be enough. Dr. Tejasree Vengala performs the Altemeier procedure at Lux Hospitals, Hyderabad, with careful attention to safe resection and durable healing.

Suitable for elderly or frail patients with longer-segment full-thickness rectal prolapse where abdominal surgery is not advisable, or where the prolapse is too long for the Delorme procedure.

How the Procedure Works

Anaesthesia & Positioning

Surgery is performed under spinal or general anaesthesia. The patient is positioned for perineal access.

Prolapse Delivery

The prolapsed bowel is gently delivered through the anus to expose the entire prolapsed segment.

Resection

The redundant rectum and sigmoid colon are carefully resected, with attention to preserving healthy bowel ends.

Anastomosis

The healthy bowel ends are joined together using a hand-sewn or stapled anastomosis, restoring continuity.

Recovery & Discharge

Patients are mobilised the next day and started on soft diet. Most are discharged in 2–3 days with structured follow-up.

Outcomes

75–120 minDURATION

2–3 DaysHOSPITAL STAY

>85%SUCCESS RATE

4–6 WeeksFULL RECOVERY

Who Needs This Treatment?

→No abdominal incisions — entirely from below
→Suitable for longer prolapses
→Effective option for elderly or frail patients
→Removes redundant bowel completely
→Quick recovery without major abdominal surgery
→Improves dignity and quality of life

Altemeier is a thoughtful, kind operation — it deals with a long, troublesome prolapse from below, without putting an elderly patient through a major abdominal procedure. The relief it gives is profound, and it does so with remarkably little surgical stress.

— — Dr. Tejasree Vengala, Consultant Proctologist & Laparoscopic Surgeon, Lux Hospitals, Hyderabad

Common Questions

Frequently Asked Questions

How is Altemeier different from Delorme?+

Will my prolapse come back?+

Is the surgery painful?+

How quickly can I return to normal activities?+

Not sure which treatment is right for you?

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