Rectopexy treats rectal prolapse by mobilising and fixing the rectum to the sacrum. Modern ventral rectopexy is done laparoscopically/robotically, with less impact on bowel function and rapid recovery.
What is a rectopexy?
It is the fixation of the rectum in its normal position to correct prolapse. Modern ventral rectopexy uses a mesh with limited mobilisation, protecting the nerves and bowel function.
The aim is anatomical repair with simultaneous functional improvement (continence/evacuation), not merely mechanical fixation.
When is it needed?
It is indicated for full rectal prolapse and, in selected cases, internal prolapse/obstructed defaecation syndrome with symptoms.
In elderly or frail patients a perineal approach (e.g. Delorme/Altemeier) may be preferred, avoiding abdominal surgery, with a slightly higher recurrence.
Preparation
A proctological assessment and, as appropriate, functional/imaging evaluation of the pelvic floor (e.g. defaecography) are done so that planning is individualised.
Coexisting pelvic-floor disorders that may need combined treatment are excluded.
How it's done
Laparoscopically or robotically, the rectum is mobilised mainly from the anterior side and fixed with a mesh to the sacral promontory. Limited tissue division protects the pelvic autonomic nerves and reduces post-operative constipation.
In the perineal approach, the prolapsing segment is dealt with through the anus — a useful option for high-surgical-risk patients.
Ventral rectopexy
Ventral mesh rectopexy with limited mobilisation — nerve protection, good function.
Lap./Robotic
Fixation through small incisions with rapid recovery and low recurrence.
By symptoms
Planning adapts to the type of prolapse and bowel function.
Recovery
With the laparoscopic approach, discharge is usually in 1–2 days, with a gradual return.
Advice is given on stool regulation and avoiding straining; functional improvement (continence/evacuation) may continue over weeks.
Risks & outcomes
An operation with very good results and low recurrence in specialist hands.
Possible, usually rare, complications relate to the mesh, changes in evacuation (constipation) or recurrence; the anterior technique with limited mobilisation minimises them.
Frequently asked questions
What is ventral rectopexy?
It is the modern technique that fixes the rectum with a mesh from the anterior side, with limited tissue division — protecting the nerves and bowel function.
Is it done laparoscopically?
Yes, chiefly laparoscopically or robotically, with small incisions and rapid recovery.
Will the prolapse recur?
With the modern technique recurrence is low. Stool regulation and avoiding straining help.
Will my symptoms improve?
The aim is to correct the prolapse and improve related symptoms; outcomes are individualised to the initial picture.