Rectal prolapse is the protrusion (prolapse) of the rectum through the anus. Doctors say that a rectal prolapse is caused by weakness or loss of the usual support structures of the rectum. Laparoscopic rectopexy surgery is one of the surgical procedures used to treat patients with rectal prolapse.
During the rectopexy surgery, the rectum is usually restored back to its normal position, which stops it from protruding (prolapsing) through the anus. The rectum is secured in its place with stitches/mesh. Laparoscopic rectopexy surgery is usually performed via very small incisions made in the patient’s abdomen. The doctors use a laparoscope, which is inserted through the incision, for them to get a view of the stomach. All surgical instruments used during rectopexy surgery are placed through the small incisions.
Rectal prolapse surgery is usually indicated for a patient with rectal prolapse known to be caused by chronic constipation. Other indications for rectopexy surgery for rectal prolapse include excessively redundant sigmoid.
Once the doctor diagnoses rectal prolapse, laparoscopic rectopexy is indicated to help prevent discomfort and deteriorating incontinence and discomfort. Most doctors recommend laparoscopic rectopexy as the primary option for treating rectal prolapse.
Laparoscopic rectopexy surgery is the recommended surgical option for treating prolapsed rectum. The signs and symptoms of a prolapsed rectum resemble those of hemorrhoids, but, these symptoms usually originate higher in the body compared to hemorrhoids. A patient with a prolapsed rectum may feel a swelling or the appearance of a reddish-colored mass which protrudes from the anus.
This is mostly a temporary condition, and it occurs either during or after bowel movements. However, the condition can worsen over time and presents cases where by the end of the rectum extends out of the anal canal and requires to be pushed back into the anus with hand. This mostly occurs after usual amount of standing or walking.
First, the doctor takes the patient’s medical history and then performs a rectal examination. The patient can be asked to strain while sitting on a commode to simulate a real bowel movement. The doctor can confirm the diagnosis by visualizing the prolapse, and this helps in developing a treatment plan.
Other conditions which accompany rectal prolapse include bladder prolapse, urinary incontinence, and uterine/vaginal prolapse. Because of the number of potential problems associated with rectal prolapse, urogynecologists, urologists, and other specialists usually team together, share their ideas and evaluations and then make comprehensive treatment plans. As a result, combined surgical repairs for any of these problems can be done together.
Also, there are several tests carried out by doctors to diagnose rectal prolapse. These tests include:
Rectal prolapse can be reduced via a gentle digital pressure. Local anesthesia and sedation can be used to assist in the reduction.
Contributing factors such as constipation and diarrhea should be treated
In case of irreducible rectal prolapse and gangrene or strangulation of the prolapsed tissue, the doctor can recommend emergency surgical referral.
Partial rectal prolapse usually responds to conservative treatment, but it typically requires removal of the prolapsed mucosa.
Alternative treatment methods
Prolapsed tissue should be placed back gently using water-soluble lubricant. Parents should be advised to give their children high-fiber diet and discourage their children about straining their stool. Also, children can be given a mild laxative. A doctor can also recommend a submucosal injection of sclerosant on a regular basis.
Most elderly people can tolerate manual reduction of the prolapse. A subcutaneous circumanal rubber ring can be fitted for the elderly people who are not fit for surgery. However, this treatment method usually fails because of the rubber being either too loose or tight, which results to constipation or the prolapse re-appearing again.
The main advantage of laparoscopic surgery is that it needs few small incisions. As a result, a patient experiences less pain and less visible scars. Also, healing happens faster compared to open surgery.
As with any other surgery, laparoscopic rectopexy surgery can pose risks like infection, bleeding or anesthesia complications. Also, other medical complications as a result of rectal prolapse surgery such as pneumonia and blood clots can occur. Other risks which can occur as a result of laparoscopic rectopexy include:
After a patient undergoing a rectal prolapse surgery, a patient stays in the hospital for a brief time as they recover and also re-gain normal bowel function. The patient is then given clear fluids and the gradually solid foods as the bowel function returns to normal. Mostly, the patients who undergo laparoscopic rectopexy stay in the hospital 2 to 4 days.
The patient is advised to take a lot of fluids, eat diets with a lot of fiber and also stool softeners in the weeks after the surgery as this helps prevent constipation and straining which can cause reappearance of the rectal prolapse. Most patients usually return to their normal actives within 4 to 6 weeks after undergoing laparoscopic rectopexy.
Laparoscopic rectopexy cost varies depending on the hospital, duration of stay and the room type selected. The average laparoscopic rectopexy surgery cost also depends on whether resection of the sigmoid colon is required or not. Rectal prolapse surgery cost is also determined by duration of the surgery. Laparoscopic rectopexy surgery cost tends to be a bit higher compared to open surgery cost. The cost of rectopexy surgery is usually covered by insurance.