Laparoscopic Ventral Rectopexy

Rectal prolapse is more common in females and increases in frequency with age.

Treatment of rectal prolapse is primarily surgical; however, over 100 different procedures have been proposed for the management of this condition. The primary goals of surgery are to correct the prolapse, alleviate preoperative discomfort, and to prevent or improve fecal incontinence or constipation.

The procedures to address rectal prolapse can broadly be split into two main approaches (abdominal and perineal). In addition, as laparoscopic surgical approaches to treating colorectal disorders become more common, they are being used more frequently to repair rectal prolapse, because excellent functional results can be obtained with less surgery related trauma.

Although there is currently no established consensus as to the best surgical treatment, a laparoscopic approach to rectal prolapse repair has become increasingly popular and several studies have shown the benefits of laparoscopy when compared to open rectopexy.

In this video Albert Wolthuis describes an abdominal surgical approach for the management of a rectal prolapse, a laparoscopic ventral rectopexy. There are two steps during this operation: a first one consisting in the dissection of the anterior wall and rectovaginal septum to reach the pelvic floor musculature and preserving the lateral attachment of the rectum. The second step is the fixation of pelvic mesh and the closure of the pelvic peritoneum.