Full-thickness pouch prolapse after restorative proctocolectomy: a potential future problem treated by the new technique of external pelvic neorectal suspension (the Express procedure).

Full thickness pouch prolapse following restroative proctocolectomy is an uncommon complication but likely to become more frequent as this population of patients grows older. Conventional procedures to correct the prolapse may be impossible or significantly risk permanent ileostomy formation. The Express technique which is relatively minimally invasive, is a perineal procedure which elevates and suspends the antero-lateral walls of the prolapsing pouch to the external surface of the pelvis, utilizing strips of long lasting collagen.