Rectal prolapse is a distressing condition that is usually associated with incontinence and bowel dysfunction. There are multiple operations that correct the anatomical disability with the possibility of improving the function. The Delorme procedure is one of the modalities of treating full thickness external rectal prolapse. In elderly patients and those who are not fit for major operations, the Delorme procedure has low morbidity and mortality rate compared to the other available procedures. It can also be offered to those patients who do not wish to go through a major procedure for reasons other than fitness.

The Delorme procedure should not be offered to patients with internal prolapse or intussusception or, as per the author’s experience, those individuals in whom the distance between the distal part of the prolapse and the dentate line is fixed (due to previous surgery [e.g., procedure for prolapse and hemorrhoids], phenol injections, low rectal or anal pathology) or if the distance from the dentate line to the distal part of the prolapse is longer than 3 cm. It is also contraindicated for those patients who suffer from diarrheal bowel dysfunction and those individuals who cannot be properly positioned on the operating table. Attention should be paid to patients who suffer with inflammatory bowel diseases and those patients with a history of rectal irradiation, but each case should be individualized.

Patients should be made aware of the high recurrence rate, the possibility of redoing the procedure if needed and the fact that not much assurance can be given regarding the improvement of continence.