Peer-reviewed veterinary case report
New laparoscopic surgery avoids bowel risks in rectal prolapse
By Chandra A et al.·2026·Department of Surgical Gastroenterology, India·View original on Europe PMC →
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Original publication title: Laparoscopic-total extraperitoneal anterior rectopexy (L-TEAR)-a preliminary report.
Plain-English summary
This study looked at a new surgical method for treating complete rectal prolapse, which is when the rectum slips out of place and can cause problems like incontinence and difficulty with bowel movements. The procedure, called total extraperitoneal anterior rectopexy, is less invasive than traditional methods and avoids some of the risks associated with them. In this study, 20 patients, mostly young adults, underwent the surgery and were monitored for about eight months afterward. While two patients had a minor issue with mucosal prolapse, there were no serious complications, and many patients reported significant improvements in their bowel control and quality of life. Overall, the new surgical approach appears to be safe and effective, but more research is needed to confirm these findings over a longer period.
Abstract
<h4>Background</h4>Complete rectal prolapse, associated incontinence and obstructive symptoms, significantly impairs quality of life. Minimally invasive ventral mesh rectopexy, the current standard, being transperitoneal, entails risks of vascular, bowel injury, and adhesions, besides mesh and tack fixation issues. This study evaluates the feasibility, safety, and short-term outcomes of a novel total extraperitoneal anterior rectopexy that avoids peritoneal transgression and sacral fixation.<h4>Methods</h4>In this prospective single-center study conducted from July 2024 through the time of publishing, 20 patients (11 male, 9 female; mean age 34.6 ± 14.2 years) with complete rectal prolapse who had a body mass index < 28 kg/m<sup>2</sup> and who had not had prior abdominal surgery underwent this procedure, which involved transfascial rectal fixation to the abdominal wall with preperitoneal mesh placement. Operative variables, complications, recurrence, functional outcomes [St. Mark's Incontinence Score (SMIS), obstructed defecation syndrome (ODS) score, quality-of-life questionnaires], sigmoidoscopy, manometry, and defecography were assessed.<h4>Results</h4>Mean operative time was 181.2 ± 41.6 min, blood loss 70.6 ± 30.6 mL, and hospital stay 4.1 ± 2.7 days. During median 8-month follow-up, two patients (10%) experienced mucosal prolapse. There was no mortality nor were there major complications. Four patients developed transient hematuria, resolving conservatively. Significant improvements were observed in SMIS (18.6 ± 2.4 to 14.4 ± 2.8; p = 0.0357) and ODS scores (16.3 ± 3.2 to 8.1 ± 3.9; p < 0.0001). Quality-of-life improved, while manometric and defecographic parameters were not significantly altered.<h4>Conclusions</h4>Total extraperitoneal anterior rectopexy is feasible and safe, avoiding peritoneal entry and sacral fixation while achieving favorable early outcomes. Larger, long-term validation is needed.
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Search related cases →Original publication on Europe PMC: https://europepmc.org/article/MED/41770256