Restoration of the levator sling in the treatment of rectal procidentia

Summary The function of the levator ani muscle constitutes an important factor in maintaining the rectum in its normal position. The muscle, which is firmly fixed to the rectum, elevates, angulates, and supports the distal end of the rectum. In procidentia, this levator mechanism is often defective. We believe that this support can be restored by the placement of a fascial graft posteriorly across the lower rectum and attached anteriorly to the pubis. This puborectalis fascial sling tends to restore the natural support of the lower rectum. This type of procedure has been used successfully in five patients with severe rectal procidentia.