In the Delorme procedure for full-thickness rectal prolapse, which of the following correctly describes the technique?
- A Circumferential full-thickness resection of the prolapsed segment and coloanal anastomosis (transperineal Altemeier)
- B Mucosal stripping of the prolapsed rectum, followed by plication of the denuded muscular cuff and mucosal anastomosis ✓
- C Posterior rectopexy with or without sigmoid resection via laparoscopy
- D Placement of a Thiersch wire around the anal canal to reduce the lumen
Correct answer: B. Mucosal stripping of the prolapsed rectum, followed by plication of the denuded muscular cuff and mucosal anastomosis
Explanation
The Delorme procedure is a perineal operation involving longitudinal mucosal stripping (mucosectomy) of the prolapsed rectal segment, followed by longitudinal plication of the redundant denuded muscular coat to shorten and stiffen the bowel wall, with re-anastomosis of the mucosal edges. It is preferred in high-risk elderly patients as it avoids abdominal entry. The Altemeier procedure (option A) involves full-thickness transperineal resection.
Reference: Bailey & Love's Short Practice of Surgery, 27th ed.
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