Laparoscopic Rectopexy for Complete Rectal Prolapse

Both perineal operations and abdominal operations have been used for permanent cure of rectal prolpse. Abdominal operations are more invasive but have a lower rate of recurrence. Recently, less invasive laparoscopic surgery has been used to treat rectal prolapse. We performed laparoscopic surgery with a modified procedure in 6 patients with complete rectal prolapse who had psychosis or were elderly. The duration of surgery averaged 3 hours 23 minutes, and no patients had early postoperative complications such as bleeding. No late postoperative complications, such as recurrence and stenosis, had occurred after 6 months to 3 years of follow-up. Fecal incontinence and desire to evacuate the bowels improved after surgery in 83% of patients, but constipation improved in only one patient. Laxatives were needed to control the dyschezia in other patients. Our modified surgical technique is appropriate for patients with intercurrent psychosis and elderly patients who can tolerate general anesthesia because it requires a relatively short operation time, is associated with a low rate of recurrence, and enables oral intake and ambulation to be started soon after surgery.