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This Concept Map, created with IHMC CmapTools, has information related to: Rectal prolapse repair procedure, Step 6: Tack in the inner mucosa to the outer mucosa with four interrupted cruciate sutures with size 0 absorbable suture at four equidistant sites around the circumference of the prolapse Step 7: Place additional cruciate sutures circumferentially around the prolapse attaining complete mucosal closure (resembling a purse string). Interrupted sutures and submucosal dissection to preserve additional mucosa are used to reduce the likelihood for stricture formation. The sutures should include the full thickness of the wall of the rectum. Apply moderate to marked tension on the sutures Step 8: After rectum is sutured, pull the needles from the tube and remove the tube from the rectum, allowing the rectum to retract into place., CASE 1 RECTAL PROLAPSE REPAIR PROCEDURE Step 1: Apply epidural or general anaesthesia and reduce edema (if present) by using a topical application of a hyperosmotic solution, such as a sugar solution Step 2: Insert rubber tube into the rectum until 2 or more inches protrude, Step 2: Insert rubber tube into the rectum until 2 or more inches protrude Step 3: To fix the rubber tube in the rectum, insert the two needles at a 90 degrees angle to each other, about 1.5 cm from the necrotic portion of the prolapsed rectum close to the anal opening and entirely through the prolapsed rectum and tubing. These needles prevent the rectal tissue from retracting into the abdomen when it is incised. Precautions: In order to avoid the major blood supply, do not place a needle at the 12 o’clock position. Step 4: The removal of the necrotic portion of the rectum: dissect the exposed rectal mucosa to the level of the inner mucosa and submucosa, using a blunt dissection to create a submucosal plane toward the caudal aspect of the prolapse., Step 4: The removal of the necrotic portion of the rectum: dissect the exposed rectal mucosa to the level of the inner mucosa and submucosa, using a blunt dissection to create a submucosal plane toward the caudal aspect of the prolapse. Step 5: Push cranially the healthy outer segment of the prolapsed tissue adjacent to the mucocutaneous junction and amputate the inner segment 2 to 3 cm distal to the outer segment. Ensure to excise about 1 cm of the normal rectal tissue to ensure that the necrotic tissues left after the excision is minimal. Step 6: Tack in the inner mucosa to the outer mucosa with four interrupted cruciate sutures with size 0 absorbable suture at four equidistant sites around the circumference of the prolapse