An 82-year-old man with multiple comorbidities presents with full-thickness rectal prolapse. He is assessed as high risk for abdominal surgery. Which operation is most suitable?

• A Abdominal suture rectopexy
• B Delorme's procedure ✓
• C Ventrorectopexy with mesh
• D Laparoscopic ventral mesh rectopexy

Explanation

Delorme's procedure is a perineal operation consisting of mucosal sleeve stripping and plication of the muscular layer. It avoids an abdominal incision and general pneumoperitoneum, making it ideal for elderly or comorbid patients, though recurrence rates are higher than after abdominal rectopexy. Abdominal rectopexy procedures offer lower recurrence but carry greater operative risk. Perineal proctosigmoidectomy (Altemeier) is the alternative perineal option for very large prolapses.

Reference: Bailey and Love's Short Practice of Surgery, 27th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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