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Delormes Procedure


The classic Delormes operation is performed for people with external rectal prolapse (when the full inner lining and bowel wall falls out of the anus).

WHAT DOES THE OPERATION INVOLVE?

A classic Delormes operation is usually carried out under a general or spinal anaesthetic.

The operation is carried out through the anus (back passage), so all stiches and scars are on the inside, with no external scarring. The lining over the rectum is removed giving access to the muscle layer. This is then stitched in a fashion which makes it shorter, turning a long tube of prolapsing rectum into a short donut shape, which is placed back into the correct position, above the anus. The operation takes around one hour.

WHAT ARE THE RESULTS LIKE FROM THE SURGERY?

It will take time for your bowels to settle down into a pattern after surgery. This often takes 6-8 weeks, sometimes many months. Often the anal sphincter muscles are stretched and damaged by the external prolapse. It can take many months of diligent pelvic floor exercises to regain the strength of your muscles.

Delormes procedure has a recurrence rate for prolapse of up to 50%, considerably higher than the alternative, laparoscopic ventral mesh rectopexy. It also carries a higher risk of not improving your symptoms of faecal incontinence or obstructed defecation. This procedure is mainly recommended for patients who are deemed not fit enough to undergo laparoscopic operations or who have extensive scarring in their tummy from previous surgery.

HOW DO I PREPARE FOR SURGERY?

The hospital will contact you before your operation to arrange for you to come in for a pre-assessment visit. This normally lasts 30-60 minutes.

At your visit you will have some basic health checks to ensure you are fit for surgery. These may include:

  • Blood Pressure
  • Pulse
  • Weight
  • Urine Analysis
  • Electrocardiogram (ECG)
  • Medical History Questionaire
  • MRSA Screen

The nurse will advise whether you should continue to take any regular medication.

You will also be given instructions about when to stop eating and drinking before your operation, what to bring into hospital with you and when to arrive.

The nurse will advise whether you should continue to take any regular medication.

You will also be given instructions about when to stop eating and drinking before your operation, what to bring into hospital with you and when to arrive.

You do not normally need to take a strong laxative or bowel preparation before your operation, but you may be given an enema an hour before the operation to clear out the bottom part of your bowel.

WHAT IS THE RECOVERY LIKE AFTER THE OPERATION?

Immediately after the operation you will normally have a urinary catheter in place (a tube into your bladder) and a drip in your arm. You will be allowed to eat and drink as soon as you want after the operation, and your drip will be removed once you are drinking enough.

Your anaesthetist will talk about pain control with you before the operation but usually painkilling tablets and liquids will be enough. Usually, at 6am on the day after your operation your catheter will be removed and you can walk to the toilet to pass urine. You should be able to go home the day after the operation.

It is important to avoid constipation and straining in the first few weeks after surgery as this may damage the repair. We will give you laxatives to take for six weeks (usually Movicol). You will also be prescribed a course of antibiotics for 3-7 days.

You can shower and bathe like normal after the operation. You should be fit to drive after a week and return to work after 2-4 weeks. It is best to avoid heavy lifting (anything heavier then a full kettle) or strenuous exercise (jumping/squatting/weight lifting) for 6 weeks.

WHAT ARE THE RISKS OF THE SURGERY?

There is a small risk of bleeding after surgery. Minor bleeding is sometimes seen after 4-8 weeks when the stitches start to dissolve.

The main problem with this operation is infection. Because the wound lies within the bowel it is impossible to keep this area clean, so wound infections are very common. This may cause discomfort and can result in discharge from the back passage. A prolongation or new course of antibiotics might be necessary.

Because the procedure is performed through the anus, there is a theoretical risk of damage to the anal sphincter muscles. Because of the development of new safer equipment this risk is very minimal. If your surgeon thinks your sphincter muscle is already too weak, he or she will discuss alternative options with you.

You will have the opportunity to discuss all the risks and benefits of the operation with your surgeon before signing the consent form.


Please be advised that the information on this website is not a substitute for professional medical advice, diagnosis or treatment