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What is a Rectopexy?

J.M. Willhite
J.M. Willhite

Rectopexy is a surgical procedure used to correct rectal prolapse, a condition characterized by a weakening of the muscles that hold the rectum in place. Though the exact cause of this problem is unknown, there are several conditions that may contribute to its development. The surgery requires hospitalization, and certain physical restrictions will be necessary during recovery, but with proper aftercare, the patient’s prognosis following surgery is good. There is an increased risk of complication associated with this procedure, and the risks should be discussed with a qualified health care professional prior to surgery.

Rectal prolapse is a condition where the ligaments and muscles surrounding the rectum weaken, allowing a portion of the large intestine to protrude from the anus and the rectum to shift from its normal position. Though there is no known single cause for rectal prolapse, there are several conditions which it's been suggested may contribute to its development. Conditions which are strenuous on the body, such as chronic obstructive pulmonary disorder (COPD), whooping cough, and long-term constipation or diarrhea, may cause extreme stress on the surrounding muscles of the rectum, leading to weakness. Pregnant women and individuals of advanced age may also be at an increased risk of developing rectal prolapse.

When the muscles that hold the rectum in place are weakened, a surgical procedure known as rectopexy may be performed.
When the muscles that hold the rectum in place are weakened, a surgical procedure known as rectopexy may be performed.

Mild cases may be alleviated by a change in diet and the use of laxatives, stool softeners, or stool bulking products. To prevent straining during a bowel movement, individuals are encouraged to eat a diet high in fiber and consume plenty of liquids. Symptoms associated with rectal prolapse include the involuntary passage of stool, known as fecal incontinence, the protrusion of rectal tissue while defecating, and a discharge of mucus or blood during bowel movements.

During a rectopexy, an incision is made along the abdomen, and the rectum is separated from the surrounding tissues.
During a rectopexy, an incision is made along the abdomen, and the rectum is separated from the surrounding tissues.

Rectopexy is one of two common procedures used to correct rectal prolapse and requires the administration of a general anesthetic. Prior to surgery, an intravenous (IV) line is established to make fluid and medication administration easier. Antibiotics are given to aid with preventing infection, and the patient undergoes a bowel prep to cleanse the colon to prepare it for surgery.

Rectopexy requires hospitalization.
Rectopexy requires hospitalization.

During surgery, an incision is made along the abdomen and the rectum is separated from the surrounding tissues. The sides of the rectum are lifted and sutures are taken to secure it to the lower backbone, also known as the sacrum. In some cases, the rectum may be affixed to the sacrum with a mesh-like material that provides added reinforcement.

This procedure may be performed in conjunction with anterior resection surgery, which involves the removal of a portion of the colon. During the surgery, the section of the colon located just above the rectum is removed and the remaining portion of the colon is reattached to the rectum. This provides a straightening of the lower colon allowing for easier defecation. Both procedures may be performed laparoscopically, requiring small incisions and the use of a thin tube, or laparoscope. Recovery from laparoscopic rectopexy and anterior resection is generally less painful and shorter than conventional abdominal surgery.

Whooping cough may contribute to the development of rectal prolapse.
Whooping cough may contribute to the development of rectal prolapse.

Following surgery, the patient is placed on a liquid diet until bowel function returns to normal. He or she will be asked to restrict any activities that may cause strain, including lifting, coughing, and straining during bowel movements. With proper aftercare, a patient’s prognosis is good and complete recovery should take four to six weeks. Post-operative risks include infection, a narrowing of the rectum, and damage to the nerves and organs near the rectum. As with any procedure requiring the administration of general anesthesia, additional risks include breathing difficulty and pneumonia.

Discussion Comments

anon348374

Please tell me what immediate post operative effects I will have after a laparoscopic rectopexy. I am phobic about hospitals so please help.

anon127249

would a rectopexy procedure be advisable for a lady of 90 years?

anon79807

I recently had a rectal prolapse repair with a sigmoid resection post op 2/10. Now after several tests, a barium enema, transit time and a unsuccessful colonscopy, I found that i have to return to surgery again for a rectopexy abdominal surgery? Is this common?

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    • When the muscles that hold the rectum in place are weakened, a surgical procedure known as rectopexy may be performed.
      By: Gennadiy Poznyakov
      When the muscles that hold the rectum in place are weakened, a surgical procedure known as rectopexy may be performed.
    • During a rectopexy, an incision is made along the abdomen, and the rectum is separated from the surrounding tissues.
      By: kocakayaali
      During a rectopexy, an incision is made along the abdomen, and the rectum is separated from the surrounding tissues.
    • Rectopexy requires hospitalization.
      By: spotmatikphoto
      Rectopexy requires hospitalization.
    • Whooping cough may contribute to the development of rectal prolapse.
      By: Lisa F. Young
      Whooping cough may contribute to the development of rectal prolapse.
    • Pregnant women are susceptible to developing rectal prolapse.
      By: LanaK
      Pregnant women are susceptible to developing rectal prolapse.
    • Changing one's diet may help alleviate mild cases of rectal prolapse.
      By: Irochka
      Changing one's diet may help alleviate mild cases of rectal prolapse.
    • Following a rectopexy, a patient will be placed on a liquid diet.
      By: Mi.Ti.
      Following a rectopexy, a patient will be placed on a liquid diet.
    • During a rectopexy, the rectum may be secured to the sacrum with a mesh.
      By: Anatomical Design
      During a rectopexy, the rectum may be secured to the sacrum with a mesh.
    • During hospitalization, fluid and electrolyte replacement is typically necessary.
      By: Yong Hian Lim
      During hospitalization, fluid and electrolyte replacement is typically necessary.