Recto-sigmoidectomy for complete procidentia of the rectum : Miles' operation.

Demonstration of operation showing level of amputation. The muscular coat of the bowel is exposed and incised, opening the anterior peritoneal pouch. Control of the superior haemorrhoidal vessels and division of the rectal wall are shown. The rectum is peeled downwards. A ligature is used to secure the mesocolic vessels. Closure of the peritoneal cavity is shown, the wall of the sigmoid is sutured in layers to the remains of the rectal wall and the operation is completed by the insertion of drainage.