Ventral rectopexy

Rectopexy is the name given to an operation undertaken in which the rectum is ‘hitched up’ and returned to its normal anatomical position via a surgical incision in the abdomen.

Types of rectopexy

Rectopexy can be undertaken by mobilising the rectum from the back [posterior rectopexy] or from the front [ventral rectopexy].  The modern way to undertake rectopexy is using laparoscopic [keyhole] surgical techniques.  Recent evidence suggests that posterior rectopexy can damage the intrinsic nerves of the rectum; and ventral rectopexy appears to offer superior results.

What can be achieved by laparoscopic ventral rectopexy?

Ventral rectopexy is an effective treatment for external rectal prolapse.  In addition, when a patient is experiencing symptoms of obstructed defecation syndrome, then ventral rectopexy may be extremely helpful.

What does the operation involve?

Under a general anaesthetic, the surgeon will mobilise the rectum and create a pocket for a piece of mesh that is stitched to the front of the rectum.  The other end of this piece of mesh is then attached to the sacrum.  We would expect patients to stay in hospital for one or two nights after surgery and to be discharged with medicine to take to help maintain soft stools and avoid straining.

Results of surgery

Although the procedure does have some specific risks [that your surgeon will discuss with you in clinic], laparoscopic ventral rectopexy is a safe procedure with a low risk of serious complications.  If the surgery is undertaken for external rectal prolapse, it tends to be very effective and the results are durable with a risk of recurrence of around 5%. Significant improvement in associated symptoms of constipation and incontinence can also be anticipated.  If the procedure is undertaken for symptoms of obstructed defecation, we would expect patients to notice a significant improvement in symptoms of constipation and/or incontinence.

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