📘 Theme: Rectal Prolapse
True about the Altemeier procedure?
A. It is proctosigmoidectomy with posterior levatoroplasty
B. Done in left lateral position
C. Recurrence rate can be as high as 50%
D. Altemeier was the first person to do it
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✅ Answer: A. It is proctosigmoidectomy with posterior levatoroplasty
Explanation:
The Altemeier procedure is a perineal rectosigmoidectomy (proctosigmoidectomy) performed for complete rectal prolapse. It is commonly combined with posterior levatoroplasty, which restores pelvic floor support and helps reduce recurrence.
Why the other options are incorrect:
- B. The procedure is usually performed in the lithotomy position, not the left lateral position.
- C. Reported recurrence rates are generally 10–30%; a recurrence rate of 50% is not considered typical.
- D. Although the procedure bears Altemeier's name, he popularized and refined the operation rather than being the first to perform it.
Take-home Message:
Altemeier = Perineal rectosigmoidectomy + posterior levatoroplasty; performed in the lithotomy position; preferred perineal operation for complete rectal prolapse in elderly or high-risk patients.
Reference: Sabiston Textbook of Surgery, 22nd Edition, p. 1394.