On 2016 Jun 19, Lukas Marti commented:

We thank Dr. Stanley Goldberg for pointing out, that we do not include in our PSP operation a levatorplasty. We therefore do not as he calls it "tackle the perineal hernia". It might be that adding a levatorplasty to perineal procedures as Rehn-Delorms, Altemeier's sigmoidectomy and the described PSP, lowers recurrence rate. But there is no randomized controlled trial to prove that. On the other hand adding a levatorplasty would make the procedure more complex and therefore it would become probably more prone to complications, something we want to avoid in the very frail patients to which we offer a PSP operation.

On 2016 Jun 01, Dr, Stanley Goldberg commented:

This operation does nothing for the perineal hernia which should be attacked in a perineal operation.

On 2016 Jun 01, Dr, Stanley Goldberg commented:

This operation does nothing for the perineal hernia which should be attacked in a perineal operation.

On 2016 Jun 19, Lukas Marti commented:

We thank Dr. Stanley Goldberg for pointing out, that we do not include in our PSP operation a levatorplasty. We therefore do not as he calls it "tackle the perineal hernia". It might be that adding a levatorplasty to perineal procedures as Rehn-Delorms, Altemeier's sigmoidectomy and the described PSP, lowers recurrence rate. But there is no randomized controlled trial to prove that. On the other hand adding a levatorplasty would make the procedure more complex and therefore it would become probably more prone to complications, something we want to avoid in the very frail patients to which we offer a PSP operation.