Site-Specific Posterior Colporrhaphy and Perineorrhaphy for Rectocele

1. Introduction

2. Surgical Approach

3. Excise Anterior Wall Lappets

4. Preparation of Posterior Wall

1. Incision
2. Inject Marcaine with Epinephrine

5. Dissection

1. Incision
2. Take Down Rectovaginal Tissue - Right Side
3. Take Down Rectovaginal Tissue - Left Side

6. Reduce Rectocele

1. Approach
2. Restore Rectovaginal Septum

7. Trim Excess Vaginal Mucosa

8. Vaginal Epithelium Closure

9. Perineorrhaphy

10. Finish Vaginal Epithelium Closure

11. Final Rectal Exam

12. Post-op Remarks