title: Reconstruction of the pelvic floor using the rectus abdominis muscles after radical pelvic surgery.
abstract: OBJECTIVE
  To support the small intestine out of the pelvic cavity, many methods have been described to reconstruct the pelvic floor after radical pelvic surgery. I describe a new technique using the rectus abdominis muscles for pelvic floor reconstruction.
  
  
  METHODS
  The posterior rectus sheath and peritoneum are opened. The rectus muscles are exposed at both sides and they are divided between paired clamps at the level of the umbilicus. Then, the rectus muscles are carefully retracted downward, and the edges are sutured posteriorly to the promontorium and laterally around the linea terminalis.
  
  
  RESULTS
  This method was used in 11 patients who underwent radical pelvic surgery. Seven of 11 patients had radiation therapy started 4 weeks postoperatively. The patients were followed up for two years. No patient showed any complication such as adhesive obstruction of the bowel or radiation enteritis, even in the patients who underwent radiotherapy.
  
  
  CONCLUSIONS
  Reconstruction of the pelvic floor using the rectus abdominis muscles after radical pelvic surgery is an easy and safe technique that avoids complications and serves as a barrier to radiation injury. Therefore, we believe that this method is a promising proposal requiring further investigation in a larger number of patients.
authors.affiliation: Second Department of Propedeutic Surgery, Medical School of University of Athens, Greece.
authors.forename: Gregory
authors.initials: G
authors.lastname: Kouraklis
mesh_terms: D000368:Aged; D005260:Female; D005833:Genital Neoplasms, Female / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000637:transplantation*; D017773:Pelvic Floor / Q000473:pathology / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000379:methods*; D012004:Rectal Neoplasms / Q000601:surgery*; D012189:Retrospective Studies