Rectopexy at Oxford, The Manor Hospital

Is a rectopexy right for me?

Rectal prolapse can happen to young children, but it's most often seen in older patients who may have a history of constipation.

In some cases, treating the underlying problem causing the prolapse (i.e. constipation) may resolve it. To ease constipation, your consultant may recommend changes in your diet along with laxatives, stool softeners or bulking agents.

If conservative methods to treat your rectal prolapse aren't successful, your consultant may recommend surgery.

What happens during a rectopexy?

A rectopexy is usually done under general anaesthetic, so you'll be asleep. 

The procedure can be performed by either laparoscopic (keyhole) or open surgery. Your surgeon will choose the best method for your situation.

During the procedure

1. If you're having a laparoscopic rectopexy, your surgeon will make several small incisions (cuts) in your abdomen. They'll use these cuts to insert a laparoscope (thin telescope with a light and camera) and surgical instruments through thin tubes. If your surgeon is performing open surgery they'll make a larger incision in your abdomen
2. Next, they'll place your rectum back into your body and attach it to the bony area above your tailbone, just below your spine (your sacrum)
3. Sometimes surgical mesh is used to give your rectum more support, and a portion of your colon may also be removed
4. Finally, your surgeon will close your wound with stitches or staples.

After the procedure

Afterwards you'll be taken to a recovery area where you'll wake up. The healthcare team will monitor you and give you medication for pain relief.

You may have a catheter in your bladder to help you pass urine. This is usually removed the day after your surgery.

Recovery from a rectopexy

Most people make a good recovery from rectopexy and return to normal activities after 4–6 weeks, depending on the type of surgery.

Short-term recovery

You should be able to go home 1–3 days after the operation, depending on what surgical method your surgeon used. Keyhole surgery is associated with less pain, less scarring and a faster return to normal activities than open surgery.

You'll be able to have something to eat as soon as you want to after the operation. You may be given laxatives to begin with to help you have more comfortable bowel movements.

You won't be able to drive so please arrange for someone to drive you home on your day of discharge.

Managing your recovery at home

• Follow the dietary advice and restrictions we give you
• Continue to take any medication as prescribed
• Avoid any strenuous activity or heavy lifting for 6 weeks
• To prevent a recurrence of the prolapse, it's important to avoid straining while moving your bowels.

Time off work

This will depend on your type of surgery, the kind of work you do, as well as how you feel – discuss any return to work with your consultant.

Complications of a rectopexy

As with any surgical procedure, there's a small chance of complications, such as:

• pain
• bleeding
• bruising
• infection
• blood clots (deep vein thrombosis – DVT).

Specific complications of rectopexy may include:

• bowel obstruction
• bowel incontinence
• damage to organs or nerves in the area
• failure of any joining made during the procedure
• recurrence of prolapse
• changes to bowel habits (diarrhoea or increased constipation).

The healthcare team will do their best to minimise any risks. Make sure you discuss any concerns you have about these complications with your consultant.