Operation for Rectal Prolapse (Thiersch)

Abstract

Prolapse of the rectum is, in fact, a form of intussusception with the proximal rectum and the sigmoid colon sliding through the anal canal to the outside. The concept behind the Thiersch operation is to prevent this intussusception by narrowing the diameter of the anal canal. This may be accomplished by encircling the anal sphincters with a heavy No. 20 SWG silver wire. By tying the encircling ligature with sufficient tension, intussusception and prolapse is prevented. Unfortunately, in patients who have large prolapses the wire either breaks, producing a recurrence of the prolapse, or the wire cuts through the tissues, causing an infection (Goligher) . In the latter case the wire must be removed. It is uncommon for the wire repairs to last more than 1–2 years subsequent to operation.