Two Different Procedures, One Confusing Name
The ambiguity surrounding the term 'DeLorme procedure' is rooted in history, as two separate medical professionals developed distinct techniques that carry the same namesake. The first is a surgical procedure for a colorectal condition, while the second is a rehabilitative technique for muscle strengthening. This article will provide clarity on both, addressing what is the DeLorme procedure done for in each context.
The Surgical DeLorme Procedure for Rectal Prolapse
Described by French military surgeon Edmond Delorme in 1900, this surgical procedure is a perineal approach used to treat full-thickness rectal prolapse. Rectal prolapse occurs when the final segment of the large intestine (the rectum) turns inside-out and protrudes through the anus. It is an uncomfortable condition that can cause significant distress, leading to complications like incontinence or bleeding.
What the Surgical Procedure Involves
This is a minimally invasive surgery performed via the perineum (the area around the anus), making it a less intensive option than abdominal surgery. The steps generally include:
- The surgeon makes a circular incision in the mucosa (lining) of the prolapsed rectum, typically just above the dentate line.
- The mucosa is then stripped away, revealing the underlying muscular wall of the rectum.
- The surgeon then pleats or plicates (bunches up and stitches) the exposed muscle wall to shorten and tighten the rectum, effectively pulling it back into place.
- The remaining mucosal edges are then stitched back together to complete the repair.
Who is a Candidate for Surgical DeLorme?
This perineal technique is often recommended for specific patient populations, particularly those who may not be suitable for more extensive abdominal surgery. Reasons may include:
- Elderly or frail patients with significant medical comorbidities.
- Patients with a shorter rectal prolapse.
- Individuals who have previously undergone abdominal surgeries, where another laparotomy might be risky.
The Physical Therapy DeLorme Method
In the 1940s, U.S. Army physician Dr. Thomas L. DeLorme developed a system of progressive resistance exercises (PRE) for muscle rehabilitation. Initially created to aid injured servicemen, this technique laid the groundwork for modern resistance training in physical therapy. The DeLorme method focuses on building muscular strength through a specific, structured increase in weight lifted over a series of sets.
How the Progressive Resistance Exercise (PRE) Protocol Works
In the classic DeLorme protocol, a patient performs three sets of repetitions, with the weight increasing in each set. This is centered around the concept of a "10-repetition maximum" (10RM), which is the heaviest weight that can be lifted for 10 repetitions. A typical session would look like this:
- Set 1: 10 repetitions at 50% of the patient's 10RM.
- Set 2: 10 repetitions at 75% of the patient's 10RM.
- Set 3: 10 repetitions at 100% of the patient's 10RM.
Over time, as the patient gets stronger, their 10RM is reevaluated, and the resistance is progressively increased. This methodical approach ensures safe and effective muscle strengthening.
Comparing the Two DeLorme Procedures
The following table outlines the key differences between the two procedures that share the DeLorme name.
| Feature | Surgical DeLorme (Edmond Delorme, 1900) | Physical Therapy DeLorme (Thomas L. DeLorme, 1940s) |
|---|---|---|
| Purpose | Surgical repair of rectal prolapse | Muscle strengthening and rehabilitation |
| Medical Field | Colorectal Surgery | Physical Therapy and Rehabilitation |
| Method | Perineal approach involving mucosal stripping and muscle plication | Progressive Resistance Exercise (PRE) program |
| Application | Treats full-thickness rectal prolapse, especially in elderly or high-risk patients | Strengthens muscles following injury, illness, or surgery |
| Developer | French military surgeon Edmond Delorme | U.S. Army physician Dr. Thomas L. DeLorme |
Conclusion: The Importance of Context
When someone asks, "What is the DeLorme procedure done for?", the answer is entirely dependent on the medical specialty. In a surgical context, it refers to a perineal operation for rectal prolapse. In the world of rehabilitation, it is a foundational technique for progressive resistance exercise. While both are named after medical professionals named DeLorme, they are completely unrelated in practice. This distinction is vital for patients seeking information about their treatment options or for students learning about medical history. For more detailed information on the surgical procedure, consult authoritative sources such as the National Institutes of Health.
