Over the past one hundred years many different operations have been performed for rectal prolapse. None has been ideal and the search for a perfect operation continues. Operations may be performed either an abdominal approach or through the anus.
Most recently, laparoscopic or robotic ventral rectopexy has become the procedure of choice for the vast majority of patients. Keyhole surgery is used to place synthetic mesh between the front of the rectum and the back of the vagina. This prevents inversion of the rectum which initiates complete prolapse through the anus. Generally a resorbable mesh is used in order to minimize the risk of deep pelvic infections, mesh erosion or chronic pelvic pain. These problems have been reported with the use of permanent mesh in gynaecological surgery.
The operation is performed under general anesthesia by a skilled laparoscopic surgeon. Patients are hospitalised for 48-96 hours. Recurrence rates are less than 10%.