Total rectal prolapse, internal prolapse - Solitary rectal ulcer syndrome and rectocele

Abstract

Surgical treatment of rectal prolapse remains one of the most controversial topics in colorectal surgery. Different views and a large number of (named) operations are described in the surgical literature. For no particular reason, different operations have been in vogue in different continents and surgeons base their choice merely on anecdotal personal experience. There is a lack of randomized trials comparing different techniques and approaches. This chapter aims to critically describe the most frequently applied perineal and abdominal techniques. Surgeons should master both approaches to allow a surgical approach that is tailored to the individual patient. The introduction of laparoscopy has significantly reduced the morbidity of an abdominal approach. Newer techniques focus on a less extensive mobilization of the rectum to avoid cumbersome postoperative constipation. Evaluation of surgery for rectal prolapse should not only focus on recurrence, but should also include functional aspects. © 2010 Springer-Verlag Berlin Heidelberg.