Rectopexy is a surgical procedure used to correct rectal prolapse, a condition characterized by a weakening of the muscles that hold the rectum in place. Though the exact cause of this problem is unknown, there are several conditions that may contribute to its development. The surgery requires hospitalization, and certain physical restrictions will be necessary during recovery, but with proper aftercare, the patient’s prognosis following surgery is good. There is an increased risk of complication associated with this procedure, and the risks should be discussed with a qualified health care professional prior to surgery.
Rectal prolapse is a condition where the ligaments and muscles surrounding the rectum weaken, allowing a portion of the large intestine to protrude from the anus and the rectum to shift from its normal position. Though there is no known single cause for rectal prolapse, there are several conditions which it's been suggested may contribute to its development. Conditions which are strenuous on the body, such as chronic obstructive pulmonary disorder (COPD), whooping cough, and long-term constipation or diarrhea, may cause extreme stress on the surrounding muscles of the rectum, leading to weakness. Pregnant women and individuals of advanced age may also be at an increased risk of developing rectal prolapse.
Mild cases may be alleviated by a change in diet and the use of laxatives, stool softeners, or stool bulking products. To prevent straining during a bowel movement, individuals are encouraged to eat a diet high in fiber and consume plenty of liquids. Symptoms associated with rectal prolapse include the involuntary passage of stool, known as fecal incontinence, the protrusion of rectal tissue while defecating, and a discharge of mucus or blood during bowel movements.
Rectopexy is one of two common procedures used to correct rectal prolapse and requires the administration of a general anesthetic. Prior to surgery, an intravenous (IV) line is established to make fluid and medication administration easier. Antibiotics are given to aid with preventing infection, and the patient undergoes a bowel prep to cleanse the colon to prepare it for surgery.
During surgery, an incision is made along the abdomen and the rectum is separated from the surrounding tissues. The sides of the rectum are lifted and sutures are taken to secure it to the lower backbone, also known as the sacrum. In some cases, the rectum may be affixed to the sacrum with a mesh-like material that provides added reinforcement.
This procedure may be performed in conjunction with anterior resection surgery, which involves the removal of a portion of the colon. During the surgery, the section of the colon located just above the rectum is removed and the remaining portion of the colon is reattached to the rectum. This provides a straightening of the lower colon allowing for easier defecation. Both procedures may be performed laparoscopically, requiring small incisions and the use of a thin tube, or laparoscope. Recovery from laparoscopic rectopexy and anterior resection is generally less painful and shorter than conventional abdominal surgery.
Following surgery, the patient is placed on a liquid diet until bowel function returns to normal. He or she will be asked to restrict any activities that may cause strain, including lifting, coughing, and straining during bowel movements. With proper aftercare, a patient’s prognosis is good and complete recovery should take four to six weeks. Post-operative risks include infection, a narrowing of the rectum, and damage to the nerves and organs near the rectum. As with any procedure requiring the administration of general anesthesia, additional risks include breathing difficulty and pneumonia.
