Rectal Prolapse Surgery

Rectal prolapse surgery is a medical procedure performed to repair a rectal prolapse, which occurs when the rectum loses its normal attachments inside the body, allowing it to protrude out through the anus.

Types of Rectal Prolapse Surgery

• Abdominal Rectopexy: This is a surgical procedure where the rectum is lifted and attached to the sacrum (a triangular bone at the base of the spine) using mesh or sutures. This can be done through an open incision or laparoscopically.
• Perineal Rectosigmoidectomy: Also known as the Altemeier procedure, this involves removing a portion of the rectum and sigmoid colon through an incision in the perineum (the area between the anus and genitals).
• Delorme Procedure: This is a type of perineal rectosigmoidectomy that involves stripping the mucosa from the prolapsed rectum, followed by plication of the muscular layer.
• STARR (Stapled Transanal Rectal Resection) Procedure: This is a minimally invasive procedure where a stapler is used to remove excess tissue and repair the rectal prolapse.

Surgical Approaches

• Open Surgery: This involves making a large incision in the abdomen to access the rectum.
• Laparoscopic Surgery: This is a minimally invasive approach where several small incisions are made and a camera and instruments are used to perform the surgery.
• Robotic-Assisted Surgery: This is a type of laparoscopic surgery that uses a robotic system to enhance visualization and precision.

Risks and Complications

• Bleeding or hemorrhage
• Infection
• Damage to surrounding organs or tissues
• Bowel obstruction or constipation
• Fecal incontinence
• Recurrence of the prolapse

Preparation and Recovery

Prior to surgery, patients may be required to undergo bowel preparation, which involves cleansing the colon and rectum. After surgery, patients can expect to spend several days in the hospital recovering. A liquid diet is often recommended for the first few days, followed by a gradual return to solid foods. Pain management and follow-up care are also important aspects of recovery.

Outcomes and Prognosis

The success rate of rectal prolapse surgery varies depending on the type of procedure and individual patient factors. In general, abdominal rectopexy has a high success rate, with up to 90% of patients experiencing significant improvement or complete resolution of symptoms. However, recurrence rates can range from 5-20%. Perineal procedures tend to have lower success rates and higher recurrence rates.

Frequently Asked Questions (FAQs)

What is rectal prolapse surgery?
Surgery to repair rectal prolapse, where the rectum loses its normal attachments and protrudes out.

Why is rectal prolapse surgery performed?
To relieve symptoms such as bowel obstruction, bleeding, and discomfort.

What are the types of rectal prolapse surgery?
Abdominal and perineal approaches, including open and laparoscopic methods.

Is rectal prolapse surgery usually elective or emergency?
Typically elective, but may be urgent in cases of incarcerated prolapse.

What are the risks of rectal prolapse surgery?
Risks include infection, bleeding, bowel injury, and potential for recurrence.

How long does recovery from rectal prolapse surgery take?
Usually several weeks to months, depending on individual factors and surgical approach.

Will rectal prolapse surgery cure the condition?
Surgery can significantly improve symptoms, but may not completely eliminate recurrence risk.

Are there alternative treatments to rectal prolapse surgery?
Conservative management options, such as dietary changes and physical therapy, may be considered for mild cases.

Can rectal prolapse surgery be performed on older adults?
Yes, but individual health status and potential risks are carefully evaluated before proceeding.

How effective is rectal prolapse surgery in relieving symptoms?
Generally effective in improving quality of life, but outcomes can vary depending on individual factors.