Laparoscopic repair of rectal prolapse: Surgical technique

Technical features of laparoscopic rectopexy include complete rectal mobili zation without division of the lateral stalks to avoid parasympathetic dene rvation and postoperative problems with defecation. Suture rectopexy is equ ally effective as posterior mesh rectopexy in preventing recurrences and el iminates the use of foreign material which is sometimes associated with int ense fibrosis, sepsis and increased constipation. According to two randomis ed studies constipation seems to be less after resection rectopexy than sut ure or posterior mesh rectopexy alone perhaps by eliminating possible kinki ng at the rectosigmoid region by falling of the redundant sigmoid colon in the pouch of Douglas. Randomized studies are, however, needed to validate t he need for colonic resection and to determine its optimal extent in patien ts who suffer from rectal prolapse, constipation and slow transit.