Skip to main content

Laparoscopic nonresectional suture rectopexy in the management of full-thickness rectal prolapse: substantive retrospective series



Numerous surgical options exist for the correction of rectal prolapse, with the optimal choice remaining controversial. The laparoscopic approach has proved to be popular and effective. Concern exists about nonresectional rectopexy in the form of intractable postoperative constipation. The authors present their experience with nonresectional laparoscopic suture rectopexy.


All patients presenting with a full-thickness rectal prolapse between August 1994 and August 2009 who proved to be fit for a general anesthesia were offered a laparoscopic repair. Data were entered into a database, then prospectively and retrospectively analyzed. The data recorded included patient demographics, preoperative symptoms, conversion to open procedure, length of hospital stay, and postoperative complications. Preoperative Cleveland Clinic Incontinence Scores (CCIS) were calculated. Follow-up evaluation was by telephone questionnaire. Postoperative constipation, recurrence, and CCIS were noted.


The series included 72 patients (71 women, 98%) with a median age of 72 years (range, 24–88 years). The median follow-up period was 48 months (range, 5–144 months). A total of 13 patients were lost to follow-up evaluation. The median operating time was 98 min (range, 35–200 min), and the median hospital stay was 2 days (range, 1–29 days). Three conversions to open procedure (5%) were performed. The median preoperative CCIS was 9.54 compared with 4.44 postoperatively (p = 0.024). The complications included one postoperative bleed requiring transfusion, one port-site abscess requiring incision and drainage, one postoperative retention of urine, and one chest infection. Postoperatively, 10 patients (17%) reported occasional constipation not requiring intervention, and an additional 10 patients (17%) reported more severe constipation, all managed successfully with regular laxatives. The patients followed up experienced six recurrences (9%). No postoperative deaths occurred.


Laparoscopic abdominal suture rectopexy without resection is safe and effective for the treatment of full-thickness rectal prolapse.

This is a preview of subscription content, access via your institution.


  1. Tou S, Brown SR, Malik AI, Nelson RL (2008) Surgery for complete rectal prolapse in adults. Cochrane Database Syst Rev 2008(4):CD001758

    Google Scholar 

  2. Lieberth M, Kondylis LA, Reilly JC, Kondylis PD (2009) The Delorme repair for full-thickness rectal prolapse: a retrospective review. Am J Surg 197:418–423

    PubMed  Article  Google Scholar 

  3. Watts AM, Thompson MR (2000) Evaluation of Delorme’s procedure as a treatment for full-thickness rectal prolapse. Br J Surg 87:218–222

    PubMed  Article  CAS  Google Scholar 

  4. Hsu A, Brand MI, Saclarides TJ (2007) Laparoscopic rectopexy without resection: a worthwhile treatment for rectal prolapse in patients without prior constipation. Am Surg 73:858–861

    PubMed  Google Scholar 

  5. Boccasanta P, Venturi M, Reitano MC, Salamina G, Rosati R, Montorsi M, Fichera G, Strinna M, Peracchia A (1999) Laparotomic vs laparoscopic rectopexy in complete rectal prolapse. Dig Surg 16:415–419

    PubMed  Article  CAS  Google Scholar 

  6. Kairaluoma MV, Viljakka MT, Kellokumpu IH (2003) Open vs laparoscopic surgery for rectal prolapse: a case-controlled study assessing short-term outcome. Dis Colon Rectum 46:353–360

    PubMed  Article  Google Scholar 

  7. Byrne CM, Smith SR, Solomon MJ, Young JM, Eyers AA, Young CJ (2008) Long-term functional outcomes after laparoscopic and open rectopexy for the treatment of rectal prolapse. Dis Colon Rectum 51:1597–1604

    PubMed  Article  Google Scholar 

  8. Solomon MJ, Young CJ, Eyers AA, Roberts RA (2002) Randomized clinical trial of laparoscopic versus open abdominal rectopexy for rectal prolapse. Br J Surg 89:35–39

    PubMed  Article  CAS  Google Scholar 

  9. Salkeld G, Bagia M, Solomon M (2004) Economic impact of laparoscopic versus open abdominal rectopexy. Br J Surg 91:1188–1191

    PubMed  Article  CAS  Google Scholar 

  10. Rockwood TH, Church JM, Fleshman JW, Kane RL, Mavrantonis C, Thorson AG, Wexner SD, Bliss D, Lowry AC (1999) Patient and surgeon ranking of the severity of symptoms associated with fecal incontinence: the fecal incontinence severity index. Dis Colon Rectum 42:1525–1532

    PubMed  Article  CAS  Google Scholar 

  11. Motson RW (1994) Direct puncture technique for laparoscopy. Ann R Coll Surg Engl 76:346–347

    PubMed  CAS  Google Scholar 

  12. Luukkonen P, Mikkonen U, Jarvinen H (1992) Abdominal rectopexy with sigmoidectomy vs rectopexy alone for rectal prolapse: a prospective, randomized study. Int J Colorectal Dis 7:219–222

    PubMed  Article  CAS  Google Scholar 

  13. McKee RF, Lauder JC, Poon FW, Aitchison MA, Finlay IG (1992) A prospective randomized study of abdominal rectopexy with and without sigmoidectomy in rectal prolapse. Surg Gynecol Obstet 174:145–148

    PubMed  CAS  Google Scholar 

  14. Kellokumpu IH, Vironen J, Scheinin T (2000) Laparoscopic repair of rectal prolapse: a prospective study evaluating surgical outcome and changes in symptoms and bowel function. Surg Endosc 14:634–640

    PubMed  Article  CAS  Google Scholar 

  15. Mollen RM, Kuijpers JH, van Hoek F (2000) Effects of rectal mobilization and lateral ligaments division on colonic and anorectal function. Dis Colon Rectum 43:1283–1287

    PubMed  Article  CAS  Google Scholar 

  16. Speakman CT, Madden MV, Nicholls RJ, Kamm MA (1991) Lateral ligament division during rectopexy causes constipation but prevents recurrence: results of a prospective randomized study. Br J Surg 78:1431–1433

    PubMed  Article  CAS  Google Scholar 

Download references


Jonathan Wilson, Alec Engledow, James Crosbie, Tan Arulampalam, and Roger Motson have no conflicts of interest or financial ties to disclose.

Author information

Authors and Affiliations


Corresponding author

Correspondence to Jonathan Wilson.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Wilson, J., Engledow, A., Crosbie, J. et al. Laparoscopic nonresectional suture rectopexy in the management of full-thickness rectal prolapse: substantive retrospective series. Surg Endosc 25, 1062–1064 (2011).

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI:


  • Function
  • Laparoscopic
  • Recurrence
  • Suture rectopexy