✦ RECTAL PROLAPSE · LAPAROSCOPIC

Laparoscopic Rectopexy

Q: How does rectopexy compare to perineal operations for rectal prolapse?

Rectopexy offers lower recurrence rates (5–10%) than perineal procedures such as the Delorme or Altemeier operations (15–25%). For fit patients who can tolerate an abdominal operation, rectopexy is the preferred approach.

Q: Is mesh always used in rectopexy?

Mesh is not always required. Suture rectopexy — fixation using non-absorbable sutures alone — is effective and avoids the small risk of mesh-related complications.

Q: Will bowel function improve after rectopexy?

Most patients experience improvement in prolapse symptoms and faecal incontinence. Pelvic floor physiotherapy post-operatively significantly improves continence outcomes.

Keyhole fixation of the rectum to the sacrum — gold standard for full-thickness rectal prolapse with lowest recurrence rates.

90–150 Min TREATMENT DURATION

2–4 Days CARE SETTING

Laparoscopic APPROACH

2–3 Weeks RECOVERY TIMELINE

What is Laparoscopic Rectopexy?

Laparoscopic rectopexy is the abdominal operation of choice for full-thickness rectal prolapse in fit patients. The rectum is mobilised laparoscopically and fixed to the sacral promontory using sutures or mesh, preventing re-prolapse. Resection rectopexy adds sigmoid colectomy for patients with concurrent constipation. Dr. Tagore Mohan Grandhi performs laparoscopic rectopexy using a minimally invasive approach wherever possible, offering the lowest recurrence rates among all prolapse operations at 5–10% at 5 years.

Suitable for patients with full-thickness rectal prolapse who are fit for abdominal surgery — particularly younger or active patients in whom the lower recurrence rate of rectopexy outweighs the added operative risk.

How the Procedure Works

Patient Positioning

Patient placed supine under general anaesthesia. Laparoscopic ports inserted. Steep Trendelenburg positioning allows bowel to fall away from the pelvis.

Rectal Mobilisation

Rectum mobilised in the presacral plane down to the pelvic floor, preserving the autonomic nerves.

Sacral Fixation

Mobilised rectum elevated and sutured or stapled to the presacral fascia overlying the sacral promontory. Mesh may reinforce fixation in selected cases.

Sigmoid Resection (if indicated)

In resection rectopexy, redundant sigmoid colon excised with primary anastomosis to address concurrent constipation.

Closure and Recovery

Ports closed. Oral fluids day one. Early mobilisation encouraged. High-fibre diet and pelvic floor physiotherapy post-operatively.

Outcomes

90–150 MinTREATMENT DURATION

2–4 DaysCARE SETTING

LaparoscopicAPPROACH

2–3 WeeksRECOVERY TIMELINE

Who Needs This Treatment?

→Lowest recurrence rates of all prolapse operations — 5–10% at 5 years
→Laparoscopic approach — smaller incisions, faster recovery, less post-operative pain
→Autonomic nerve preservation maintains bladder and sexual function
→Resection rectopexy simultaneously addresses constipation when present

Rectopexy gives fit patients with rectal prolapse the best chance of long-term cure. The laparoscopic approach combines the efficacy of an abdominal repair with the benefits of minimally invasive surgery.

— Dr. Tagore Mohan Grandhi, Senior Consultant Gastrointestinal Surgeon, Lux Hospitals, Hyderabad

Common Questions

Frequently Asked Questions

How does rectopexy compare to perineal operations for rectal prolapse?+

Is mesh always used in rectopexy?+

Will bowel function improve after rectopexy?+

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