Laparoscopic Management of Rectal Prolapse

Abstract

Rectal prolapse can be a disabling condition for those affected. Treatment has historically been by transanal or abdominal approaches, with transanal approaches tending to have lower morbidity, and abdominal approaches having lower recurrence rates. With the advent of laparoscopy, many of the numerous described abdominal operations have been reported with a minimally invasive approach. Although few randomized data exist, laparoscopic operations appear to provide equal rectal fixation to open surgery, with less morbidity. Coexistent symtoms such as fecal incontinence and constipation must be evaluated before surgery, so that the operation can be tailored to the needs of the individual patient. Patients with severe constipation are often offered a concomitant sigmoid resection, although this does increase the potential for complications. Patients with incontinence, diarrhea, or otherwise normal function can be offered a rectopexy without resection.