The laparoscopic approach to rectal prolapse

Abstract

This chapter represents a current opinion on the impact laparoscopy may have on the outcomes of full-thickness rectal prolapse (FTRP) surgery, and presents a concise insight on laparoscopic surgical technique, the authors' personal experience, and an overview of the literature dealing with this specific subject. Controversies remain as to which step of the abdominal surgery for FTRP contributes most to containment of recurrence rates. Rectal mobilization with suture rectopexy, performed to control prolapse and prevent impaired evacuation, can be performed via an open or laparoscopic approach. The procedure for laparoscopic suture rectopexy is reviewed, as well as laparoscopic sigmoid resection sparing the superior rectal artery. The laparoscopic approach for the treatment of rectal prolapse is the standard of care. Recurrence rates are not clearly improved by adding rectopexy, resection, or both to rectal mobilization only. Most importantly, the surgeon must choose the surgical approach according to the needs of each individual patient and consider the type of previous surgery in cases of recurrence. © 2010 Springer-Verlag Milan.