Perineal Rectosigmoidectomy (Altemeier Procedure)
The night prior to the procedure, you will be instructed to take nothing to eat or drink after midnight. In addition, you may be prescribed a bowel preparation. If ordered by your surgeon, the preparation should be taken as instructed. For more details on the specific type of bowel preparation prescribed by your surgeon, please refer to the Preparing for Procedures and Surgery section.
There is more than one option for anesthesia for an Altemeier procedure. One option is to undergo General Anesthesia, in which you are completely asleep. Your surgeon may inject local anesthesia for postoperative pain control. Another option is spinal anesthesia, where the anesthesiologist places a catheter (tube) in your back to make the region of the hemorrhoids numb. A third option is for the anesthesiologist to give intravenous sedation (but you are breathing on your own) and your surgeon to give local anesthesia in the area of the surgery. Your surgeon and anesthesiologist will discuss the anesthetic options for you at the time of your procedure.
After anesthesia is established, the prolapsed rectum will be identified from the anus. The prolapsed rectum will be excised and the two ends reconnected (anastomosis). You will have a dressing placed over the operative site.
Following an Altemeier procedure, you will be admitted to the hospital. You will receive pain medication and intravenous fluid. Often, patients are able to be discharged a day or two following surgery. You will be given a prescription for pain medication. In the 1-2 weeks following surgery, you will see your surgeon for a follow-up appointment. In the intervening time period, you should call your surgeon with any questions or concerns.