Rectopexy

Rectopexy is a surgical procedure used to treat rectal prolapse, a condition where the rectum loses its normal attachments inside the body and protrudes out through the anus.

Types of Rectopexy

• Abdominal Rectopexy: This is the most common type of rectopexy, performed through an abdominal incision or laparoscopically. It involves lifting the rectum and attaching it to the sacrum (a triangular bone at the base of the spine) using mesh or sutures.
• Perineal Rectopexy: This type of rectopexy is performed through an incision in the perineum, the area between the anus and genitals. It is often used for patients who are not good candidates for abdominal surgery.

Surgical Techniques

There are several surgical techniques used in rectopexy, including:

• Mesh Rectopexy: This involves attaching a mesh material to the sacrum and wrapping it around the rectum to lift and support it.
• Suture Rectopexy: This involves using sutures to attach the rectum to the sacrum without the use of mesh.
• Robotic-Assisted Rectopexy: This is a minimally invasive technique that uses a robotic system to assist with the surgery.

Indications and Contraindications

Rectopexy is typically indicated for patients with:

• Full-thickness rectal prolapse
• Internal rectal prolapse (also known as rectal intussusception)
• Rectal prolapse with significant symptoms, such as bowel obstruction or fecal incontinence

Contraindications for rectopexy include:

• Pregnancy or childbirth-related rectal prolapse (in some cases)
• Active inflammatory bowel disease
• Previous pelvic radiation therapy

Risks and Complications

As with any surgical procedure, rectopexy carries risks and potential complications, including:

• Bleeding or hemorrhage
• Infection
• Bowel obstruction or constipation
• Fecal incontinence
• Mesh erosion or migration (if mesh is used)

Postoperative Care and Recovery

After rectopexy, patients typically require:

• Hospitalization for several days to manage pain and prevent complications
• Pain management with medication
• Bowel rest or a low-fiber diet to allow the rectum to heal
• Follow-up appointments with their surgeon to monitor healing and remove any sutures or staples

Outcomes and Success Rates

The success rate of rectopexy varies depending on the technique used, patient factors, and the severity of the prolapse. In general:

• Abdominal rectopexy has a high success rate, with up to 90% of patients experiencing significant improvement in symptoms
• Perineal rectopexy may have a lower success rate, but is often used for patients who are not good candidates for abdominal surgery