A new technique for suture rectopexy without resection for rectal prolapse

Area of Science:

• Colorectal surgery
• Surgical innovation
• Pelvic floor disorders

Background:

• Rectal prolapse management often involves sigmoid resection.
• A new approach to abdominal suture rectopexy was evaluated to potentially avoid sigmoid resection.
• This technique preserves lateral rectal stalks in patients with normal preoperative transit.

Purpose of the Study:

• To evaluate a novel abdominal suture rectopexy technique for rectal prolapse.
• To determine the efficacy of rectopexy without sigmoid resection in patients with normal bowel transit.
• To assess the impact of this surgical approach on anal incontinence and bowel function.

Main Methods:

• 81 patients with rectal prolapse underwent assessment including manometry and transit studies.
• 70 patients with normal transit received suture rectopexy via a left pararectal approach, preserving lateral stalks.
• The procedure was performed under spinal anesthesia with a small incision, avoiding sigmoid resection.

Main Results:

• The surgery had a 9% morbidity rate with zero mortality.
• Anal incontinence improved in 81% of patients (p=0.001).
• Rectopexy improved anal manometry pressures (MRP and MSP) and maintained normal bowel transit in 90% of patients, with a 7% recurrence rate at 56 months.

Conclusions:

• Abdominal suture rectopexy with a left pararectal approach is effective for rectal prolapse.
• The technique improves anal incontinence and provides long-term prolapse control without sigmoid resection in selected patients.
• This method does not negatively impact bowel transit or cause significant constipation.