A new silicone prosthesis in the modified Thiersch operation

Abstract

Experience with a new silicone prosthesis in the modified Thiersch operation for rectal procidentia in 16 extremely poor-risk patients is presented. The technique of implantation, structural details of the prosthesis, and the clinical results are described. The use of a new silicone prosthesis in the modified Thiersch procedure is a viable alternative in this group of patients. Surgical technique is a primary determining factor in preventing complications.

Anal encirclement with a simple prosthetic sling for faecal incontinence

“…The experimental and clinical use of silicone for anal encirclement has been already reported [16,17]. The sling that we used is an elastic radiopaque material of silicone 1 centimetre wide.…”

Lomas-Cooperman technique for rectal prolapse in the elderly patient

“…Seventy-six percent of the patients acknowledged an improvement in their degree of continence [17]. Khanduja et al [18], using the same material in 16 patients, reported a morbidity of 31% (including fracture of the material in 3 cases) and a recurrence rate of 19% within a 2-year follow-up. Jackman et al [19] also used silicone prostheses in 52 patients, 90% of them over 60 years of age.…”

“…Patients were all elderly with a mean age of 84 years, a much higher figure than those reported by the series in the literature [15][16][17][18][19][20]. The procedure we used consists of a quite easy to perform and reproducible minor surgery.…”

“…However, what makes the technique so attractive is the fact that it is a simple, short and less invasive procedure. Successful modifications of the procedure using various prosthetic materials to reach better short-and long-term results have been described (Table 2) [15][16][17][18][19][20]. Poole et al [16] used vascular Dacron prostheses in 15 patients with a mean age of 65 years and a 50-month follow-up; morbidity was 33% (prosthesis infection and removal) and recurrence rate was 26%, with 2 patients undergoing re-cerclage.…”

Acute scrotum as a complication of Thiersch operation for rectal prolapse in a child

“…As a matter of fact the principle of Ekehorn's operation for rectal prolapse is based on perirectal infection to prevent the rectum from prolapse by the formation of adhesions between the rectum and the surrounding structures [11]. Infection has also been reported after a Dacron prosthesis was used instead of wire, necessitating its removal [9]. Perineal clostridial myonecrosis has been described as a complication of Thiersch operation [12].…”