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During rectal prolapse surgery
A number of different surgical techniques are used to repair rectal prolapse. Which approach your surgeon uses depends on a number of factors, such as the suspected cause of rectal prolapse, your other health problems and your surgeon's experience and preferences. Discuss your options with your surgeon.
In general, types of rectal prolapse surgery include:
Rectal prolapse repair through the anus
One type of rectal prolapse surgery involves performing surgery through the anus. Rectal prolapse surgery through the anus is sometimes called perineal rectosigmoidectomy. During this procedure, the surgeon removes a portion of the rectum and stitches the colon to the remaining rectum.
Perineal rectosigmoidectomy can be performed using regional anesthesia, during which you remain awake. It may be safer for people who aren't healthy enough to undergo general anesthesia. This approach to rectal prolapse surgery generally carries a smaller risk of complications and requires less time in the hospital. However, there is some concern that this procedure carries a higher risk of rectal prolapse recurrence.
Rectal prolapse repair through the abdomen
Rectal prolapse surgery can also be performed by making an incision in the abdomen. In this procedure, sometimes called rectopexy, the surgeon pulls the rectum back inside the body and secures the rectum to the tissue around the sacrum — the bony structure above your tailbone and below your spine. The surgeon secures the rectum with sutures or with a mesh sling that supports the rectum. In some cases, the surgeon may also remove a portion of the colon in a procedure called resection rectopexy.
The abdominal approach to rectal prolapse surgery requires general anesthetics to put you in a sleep-like state, so you won't be aware during the procedure. The abdominal approach carries a higher risk of complications, but some evidence suggests rectal prolapse may be less likely to recur using this technique.
Minimally invasive rectal prolapse surgery
Rectal prolapse surgery may also be performed using several smaller incisions in the abdomen. This procedure is sometimes called laparoscopic rectal prolapse surgery. The surgeon inserts special surgical tools and a tiny camera through the abdominal incisions to repair the rectal prolapse.
Laparoscopic rectal prolapse surgery requires general anesthesia. The minimally invasive approach may reduce the risk of complications and speed recovery, but it isn't appropriate for everyone.
After rectal prolapse surgery
After surgery you'll spend a few days in the hospital while you recover and regain your bowel function. You may begin by drinking clear liquids and eventually transition to solid foods. How much time you spend in the hospital will depend on what procedure was used for your rectal prolapse surgery.
- Marderstein EL, et al. Surgical management of rectal prolapse. Nature Clinical Practice Gastroenterology & Hepatology. 2007;4(10):552.
- Townsend CM, et al. Sabiston Textbook of Surgery. 18th ed. Philadelphia, Pa.: Saunders Elsevier; 2007. http://www.mdconsult.com/das/book/body/105659175-2/0/1565/0.html. Accessed Sept. 25, 2008.
- Rectal prolapse. American Society of Colon and Rectal Surgeons. http://www.fascrs.org/patients/conditions/rectal_prolapse/. Accessed Sept. 25, 2008.
- Felt-Bersma RJF, et al. Rectal prolapse, rectal intussusceptions, rectocele, solitary rectal ulcer syndrome, and enterocele. Gastroenterology Clinics of North America. 2008;37(3):645.
- Pemberton JH (expert opinion). Mayo Clinic, Rochester, Minn. Nov. 18, 2008.
