Skip to main content
SpringerLink
Log in

Functional Results of Laparoscopic Resection Rectopexy for Symptomatic Rectal Intussusception

  • Published:
Diseases of the Colon & Rectum

Purpose

This study was designed to assess the role of laparoscopic resection rectopexy for symptomatic rectal intussusception in patients who failed medical treatment. The functional outcomes of laparoscopic resection rectopexy were evaluated.

Methods

Patients who underwent laparoscopic resection rectopexy for rectal intussusception between July 1998 and November 2004 were identified. All patients with obstructed defecation failing medical treatment were included. Data were prospectively collected for the perioperative period. A follow-up questionnaire was used to assess functional outcome.

Results

Between 1998 and 2004, a total of 56 patients (53 females (95 percent); age range, 23–83 years) underwent laparoscopic resection rectopexy for rectal intussusception. The median operative time was 123 minutes. Morbidity was 7 percent, and there was no mortality. Fifty-two patients were available for follow-up, and of these 33 (63 percent) reported an overall improvement in their function after surgery. Of 28 patients suffering constipation, 15 (53 percent) reported an improvement in bowel frequency. Sixty-seven percent of patients incontinent before surgery improved. Symptoms of incomplete evacuation resolved in 38 percent of affected patients. Thirty-six percent of patients needing to strain at stool did not have this problem after surgery. Median follow-up was 44 (range, 15–92) months.

Conclusions

The management of patients with rectal intussusception and obstructed defecation failing medical treatment is challenging. Laparoscopic resection rectopexy is an option that might offer symptomatic relief and improved function. Further studies are required to define the selection criteria to optimize the outcome in this patient group.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. T Ihre (1990) ArticleTitleIntussusception of the rectum and the solitary rectal ulcer syndrome Ann Med 24 419–423

    Google Scholar 

  2. R Goei J Engelshofen Particlevan H Schouten C Baeten C Stassen (1989) ArticleTitleAnorectal function: defecographic measurement in asymptomatic subjects Radiology 173 137–141 Occurrence Handle2780999 Occurrence Handle1:STN:280:BiaA1cjmtlE%3D

    PubMed  CAS  Google Scholar 

  3. F Selvaggi G Pesce E Scotto Di Carlo V Maffetone S Canonico (1990) ArticleTitleEvaluation of normal subjects by defecographic technique Dis Colon Rectum 33 698–702 Occurrence Handle2376227 Occurrence Handle10.1007/BF02150748 Occurrence Handle1:STN:280:By%2BA38bptFA%3D

    Article  PubMed  CAS  Google Scholar 

  4. A Mellgren S Bremmer C Johansson et al. (1994) ArticleTitleDefecography. Results of investigations in 2816 patients Dis Colon Rectum 37 1133–1141 Occurrence Handle7956583 Occurrence Handle10.1007/BF02049817 Occurrence Handle1:STN:280:ByqD2cvms1E%3D

    Article  PubMed  CAS  Google Scholar 

  5. L Dvorkin M Gladman J Epstein et al. (2005) ArticleTitleRectal intussusception in symptomatic patients is different from that in asymptomatic volunteers Br J Surg 92 866–872 Occurrence Handle15898121 Occurrence Handle10.1002/bjs.4912 Occurrence Handle1:STN:280:DC%2BD2MzitV2quw%3D%3D

    Article  PubMed  CAS  Google Scholar 

  6. L Dvorkin C Knowles M Scott N Williams P Lunniss (2005) ArticleTitleRectal intussusception: characterization of symptomatology Dis Colon Rectum 48 824–831 Occurrence Handle15785903 Occurrence Handle10.1007/s10350-004-0834-2

    Article  PubMed  Google Scholar 

  7. J Choi Y Hwang M Salum et al. (2001) ArticleTitleOutcome and management of patients with large rectoanal intussusception Am J Gastroenterol 96 740–744 Occurrence Handle11280544 Occurrence Handle10.1111/j.1572-0241.2001.03615.x Occurrence Handle1:STN:280:DC%2BD3M7ovFOktA%3D%3D

    Article  PubMed  CAS  Google Scholar 

  8. R Kruyt J Delemarre H Gooszen H Vogel (1990) ArticleTitleSelection of patients with internal intussusception of the rectum for posterior rectopexy Br J Surg 77 1183–1184 Occurrence Handle2224470 Occurrence Handle1:STN:280:By6D38fmsFc%3D

    PubMed  CAS  Google Scholar 

  9. K Madbouly A Senagore C Delaney H Duepree K Brady V Fazio (2003) ArticleTitleComparison of the laparoscopic Wells procedure and laparoscopic resection with rectopexy Surg Endosc 17 99–103 Occurrence Handle12360372 Occurrence Handle10.1007/s00464-002-8511-9 Occurrence Handle1:STN:280:DC%2BD3s%2FmtFKjsA%3D%3D

    Article  PubMed  CAS  Google Scholar 

  10. E Xynos E Chrysos J Tsiaoussis E Epanomeritakis J Vassilakis (1999) ArticleTitleResection rectopexy for rectal prolapse Surg Endosc 13 862–864 Occurrence Handle10449839 Occurrence Handle10.1007/s004649901120 Occurrence Handle1:STN:280:DyaK1MzotVKmsw%3D%3D

    Article  PubMed  CAS  Google Scholar 

  11. L Ashari J Lumley A Stevenson R Stitz (2005) ArticleTitleLaparoscopically-assisted resection rectopexy for rectal prolapse: ten years’ experience Dis Colon Rectum 48 982–987 Occurrence Handle15785889 Occurrence Handle10.1007/s10350-004-0886-3

    Article  PubMed  Google Scholar 

  12. I Kellokumpu J Vironen T Scheinin (2000) ArticleTitleLaparoscopic repair of rectal prolapse: a prospective study evaluating surgical outcome and changes in symptoms and bowel function Surg Endosc 14 634–640 Occurrence Handle10948299 Occurrence Handle10.1007/s004640000017 Occurrence Handle1:STN:280:DC%2BD3M7gvFWmtw%3D%3D

    Article  PubMed  CAS  Google Scholar 

  13. S Benoist N Taffinder S Gould A Chang A Darzi (2001) ArticleTitleFunctional results two years after laparoscopic rectopexy Am J Surg 182 168–173 Occurrence Handle11574090 Occurrence Handle10.1016/S0002-9610(01)00672-9 Occurrence Handle1:STN:280:DC%2BD3Mrisl2iuw%3D%3D

    Article  PubMed  CAS  Google Scholar 

  14. A Stevenson R Stitz J Lumley (1998) ArticleTitleLaparoscopic-assisted resection rectopexy for rectal prolapse: early and medium follow-up Dis Colon Rectum 41 46–54 Occurrence Handle9510310 Occurrence Handle10.1007/BF02236895 Occurrence Handle1:STN:280:DyaK1c7mvFWgsg%3D%3D

    Article  PubMed  CAS  Google Scholar 

  15. G Browning A Parks (1983) ArticleTitlePostanal repair for neuropathic fecal incontinence: correlation of clinical results and anal canal pressures Br J Surg 70 101–104 Occurrence Handle6824891 Occurrence Handle1:STN:280:BiyC38fitVA%3D

    PubMed  CAS  Google Scholar 

  16. B Broden B Snellman (1968) ArticleTitleProcidentia of the rectum studied with cineradiography: a contribution to the discussion of causative mechanism Dis Colon Rectum 11 330–347 Occurrence Handle5683626 Occurrence Handle1:STN:280:CCaD3M7ot1M%3D

    PubMed  CAS  Google Scholar 

  17. A Mellgren I Schultz C Johansson A Dolk (1997) ArticleTitleInternal rectal intussusception seldom develops into total rectal prolapse Dis Colon Rectum 40 817–820 Occurrence Handle9221859 Occurrence Handle10.1007/BF02055439 Occurrence Handle1:STN:280:ByiA28vptFQ%3D

    Article  PubMed  CAS  Google Scholar 

  18. P Shorvon S Hugh ParticleMc N Diamant et al. (1989) ArticleTitleDefecography in normal volunteers: results and implications Gut 30 1737–1749 Occurrence Handle2612988 Occurrence Handle1:STN:280:By%2BC38fktFU%3D

    PubMed  CAS  Google Scholar 

  19. J Thompson A Chen P Pettit M Bridges (2002) ArticleTitleIncidence of occult rectal prolapse in patients with clinical rectoceles and defecatory dysfunction Am J Obstet Gynecol 187 1494–1500 Occurrence Handle12501052 Occurrence Handle10.1067/mob.2002.129162

    Article  PubMed  Google Scholar 

  20. C Johansson T Ihre S Alback (1985) ArticleTitleDisturbances in the defecation mechanism with special reference to intussusception of the rectum Dis Colon Rectum 28 920–924 Occurrence Handle4064851 Occurrence Handle1:STN:280:BimD2MrhslM%3D

    PubMed  CAS  Google Scholar 

  21. J Tsiaoussis E Chrysos E Athanasakis et al. (2005) ArticleTitleRectoanal intussusception: presentation of the disorder and late results of resection rectopexy Dis Colon Rectum 48 838–844 Occurrence Handle15747074 Occurrence Handle10.1007/s10350-004-0850-2

    Article  PubMed  Google Scholar 

  22. J McCue J Thomson (1990) ArticleTitleRectopexy for internal rectal intussusception Br J Surg 77 632–634 Occurrence Handle2383728 Occurrence Handle1:STN:280:By%2BA2crhtl0%3D

    PubMed  CAS  Google Scholar 

  23. E Kiff P Barnes M Swash (1984) ArticleTitleEvidence of pudendal neuropathy in patients with perineal descent and chronic straining at stool Gut 24 1279–1282

    Google Scholar 

  24. M Swash M Henry S Snooks (1985) ArticleTitleUnifying concept of pelvic floor disorders and incontinence J R Soc Med 78 906–911 Occurrence Handle2999388 Occurrence Handle1:STN:280:BimD283ksV0%3D

    PubMed  CAS  Google Scholar 

  25. W Orrom D Bartolo R Miller N Mortensen A Roe (1991) ArticleTitleRectopexy is an ineffective treatment for obstructed defecation Dis Colon Rectum 34 41–46 Occurrence Handle1991419 Occurrence Handle10.1007/BF02050205 Occurrence Handle1:STN:280:By6C387ptl0%3D

    Article  PubMed  CAS  Google Scholar 

  26. J Christiansen B Zhu O Rasmussen M Sørensen (1992) ArticleTitleInternal rectal intussusception: results of surgical repair Dis Colon Rectum 35 1026–1029 Occurrence Handle1425046 Occurrence Handle10.1007/BF02252991 Occurrence Handle1:STN:280:ByyD2cfktl0%3D

    Article  PubMed  CAS  Google Scholar 

  27. W Tets Particlevan J Kuijpers (1995) ArticleTitleInternal rectal intussusception: fact or fancy? Dis Colon Rectum 38 1080–1083 Occurrence Handle7555423 Occurrence Handle10.1007/BF02133982

    Article  PubMed  Google Scholar 

  28. J Christiansen P Hesselfeldt M Sørensen (1995) ArticleTitleTreatment of internal rectal intussusception in patients with chronic constipation Scand J Gastroenterol 30 470–472 Occurrence Handle7638574 Occurrence Handle1:STN:280:ByqA28rns1E%3D

    PubMed  CAS  Google Scholar 

  29. J Briel W Schouten M Boerma (1997) ArticleTitleLong–term results of suture rectopexy in patients with fecal incontinence associated with incomplete rectal prolapse Dis Colon Rectum 40 1228–1232 Occurrence Handle9336118 Occurrence Handle10.1007/BF02055169 Occurrence Handle1:STN:280:ByiH2sros1M%3D

    Article  PubMed  CAS  Google Scholar 

  30. W Graf U Karlbom L Påhlman S Nilsson S Ejerblad (1996) ArticleTitleFunctional results after abdominal suture rectopexy for rectal prolapse or intussusception Eur J Surg 162 904–911

    Google Scholar 

  31. F Lazorthes R Gamagami P Cabarrot S Muhammad (1998) ArticleTitleIs rectal intussusception a cause of idiopathic incontinence? Dis Colon Rectum 41 602–605 Occurrence Handle9593243 Occurrence Handle10.1007/BF02235267 Occurrence Handle1:STN:280:DyaK1c3lsVSktw%3D%3D

    Article  PubMed  CAS  Google Scholar 

  32. I Kellokumpu J Vironen T Scheinin (2000) ArticleTitleLaparoscopic repair of rectal prolapse Surg Endosc 14 634–640 Occurrence Handle10948299 Occurrence Handle10.1007/s004640000017 Occurrence Handle1:STN:280:DC%2BD3M7gvFWmtw%3D%3D

    Article  PubMed  CAS  Google Scholar 

  33. E Johnson E Carlsen O Mjåland A Drolsum (2002) ArticleTitleResection rectopexy for internal rectal intussusception reduces constipation and incomplete evacuation of stool Eur J Surg 588 51–56

    Google Scholar 

  34. B Holström G Brodén A Dolk (1986) ArticleTitleResults of the Ripstein operation in the treatment of rectal prolapse and internal rectal procidentia Dis Colon Rectum 29 845–848

    Google Scholar 

  35. H Bruch A Herold T Schiedeck O Schwandner (1999) ArticleTitleLaparoscopic surgery for rectal prolapse and outlet obstruction Dis Colon Rectum 42 1189–1195 Occurrence Handle10496560 Occurrence Handle10.1007/BF02238572 Occurrence Handle1:STN:280:DyaK1MvisVykuw%3D%3D

    Article  PubMed  CAS  Google Scholar 

  36. A Ommer K Albrecht F Wenger MK Walz (2006) ArticleTitleSTARR: a new option in the treatment of obstructive defecation syndrome Langenbecks Arch Surg 391 32–37 Occurrence Handle16402274 Occurrence Handle10.1007/s00423-005-0004-6 Occurrence Handle1:STN:280:DC%2BD28%2Fmt1eltA%3D%3D

    Article  PubMed  CAS  Google Scholar 

  37. G Dodi R Pietroletti G Milito G Binda M Pescatori (2003) ArticleTitleBleeding, incontinence, pain and constipation after STARR for obstructive defecation Tech Coloproctol 7 148–153 Occurrence Handle14628157 Occurrence Handle10.1007/s10151-003-0026-4 Occurrence Handle1:STN:280:DC%2BD3srkvV2rsQ%3D%3D

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Surgery, Colorectal Unit, Royal Brisbane and Women’s Hospital, Cnr Butterfield St and Bowen Bridge Rd, Herston, Queensland, 4029, Australia

    Michael von Papen F.R.A.C.S., Luai H. S. Ashari M.D., John W. Lumley F.R.A.C.S., Andrew R. L. Stevenson F.R.A.C.S. & Russell W. Stitz F.R.A.C.S.

Authors
  1. Michael von Papen F.R.A.C.S.
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Luai H. S. Ashari M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. John W. Lumley F.R.A.C.S.
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Andrew R. L. Stevenson F.R.A.C.S.
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Russell W. Stitz F.R.A.C.S.
    View author publications

    You can also search for this author in PubMed Google Scholar

Additional information

Reprints are not available.

About this article

Cite this article

von Papen, M., Ashari, L.H.S., Lumley, J.W. et al. Functional Results of Laparoscopic Resection Rectopexy for Symptomatic Rectal Intussusception. Dis Colon Rectum 50, 50–55 (2007). https://doi.org/10.1007/s10350-006-0781-1

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10350-006-0781-1

Key words

Search

Navigation