Abdomino-Perineal Repair of Large Pulsion Enterocoele (A.P.R.E.)
dissection and excision of the cul-de-sac
identification of both ureters from the pelvic brim to the broad ligaments, and then clearing the pelvic surface of each levator muscle mass
identification of the levator hiatus from above and below, and its closure by sutures passed from below through the right and left muscle masses, to be tied on the pelvic aspect
obliteration of the denuded pelvic cavity with a series of purse-string sutures, followed by high peritoneal closure and finally
KeywordsAnal Canal Vaginal Wall Rectal Prolapse Anterior Vaginal Wall Vaginal Vault
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