Procidentia of the rectum: The Ripstein operation

Mr. Chairman, fellow's and guests. Countless operations for the repair of rectal prolapse have been described. Of these, only two are currently being used by large numbers of surgeons. The Charles Wells, or Ivalon-sponge, operation is favored by surgeons in the United Kingdom. The Charles Ripstein, or Teflon-sling, operation is favored by surgeons in the United States and Australia. I feel that my experience may be of interest to you, as I have worked with Charles Wells and have performed both types of operation. Previous papers have described the operations more than adequately; however, I would like to make two comments about technique; first, I doubt whether any" two surgeons do the Ivalon-sponge operation in exactly the same way, and second, Charles Ripstein states that the sutures holding his sling must go through sacral bone. A lot of surgeons have modified his operation and don' t do it the way he described it. The object of both of these operations is to fix the rectum to the sacrum, so that when the patient strains at defecation, the bowel will be pushed up against the sacrum rather than through the anus. Both of these operations cure prolapse in approximately 95 per cent of cases. In fact,