Perineal Stapled Resection with Linear Staplers for External Rectal Prolapse

and internal prolapse. Rectal prolapse is an anatomic abnormality and requires surgical resection. Numerous procedures have been described for the treatment of complete rectal prolapse, and these are classified as perineal or abdominal approaches. Perineal procedures such as the Delorme procedure, Altemeier operation (perineal rectosigmoidectomy), Thiersch procedure (anal encirclement), McCann procedure, Lockhart-Mummery operation, and Wyatt perineal rectopexy are suitable for older and high-risk patients. The Delorme and Altemeier procedures are the most commonly used perineal procedures. Recently, internal rectal prolapse has been successfully treated with stapled transanal rectal resection (STARR) using circular staplers. Longo developed the Contour® Transtar stapler (STR5G; Ethicon Endo-Surgery, Cin-cinnati, OH) to increase the volume of resected tissue. Then, Roland et al. modified the STARR procedure to resect external rectal prolapse. Tepetes described a local treatment for loop colostomy prolapse using a linear stapling device. Now, we have modified this technique to treat external rectal prolapse using 2 linear staplers.