Peer-reviewed veterinary case report
How surgeons worldwide perform rectopexy for rectal prolapse
By Gialamas E et al.·2026·Geneva University Hospitals·View original on Europe PMC →
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Original publication title: Surgeon preferences and practice patterns in rectopexy: Results of an international survey.
Plain-English summary
Rectopexy is a surgery used to fix rectal prolapse, which is when the rectum slips out of place. A recent international survey of 226 surgeons from 36 countries found that while most surgeons follow similar steps during the procedure, their techniques and preferences can vary quite a bit. For example, nearly 80% of surgeons give antibiotics before surgery, and most prefer minimally invasive methods, particularly laparoscopy. There are also differences in how surgeons use mesh to support the rectum and how they prepare the bowel before surgery. Overall, this survey highlights the need for updated guidelines to help standardize how rectal prolapse surgeries are performed around the world.
Abstract
<h4>Aim</h4>Rectopexy is the preferred abdominal intervention for rectal prolapse. Despite similar procedural steps - rectal mobilisation, prolapse reduction, and fixation - techniques vary widely, and onsensus on the optimal approach is lacking. This study aimed to assess global surgeon preferences and practices in rectopexy.<h4>Methods</h4>An international 28-item online survey was distributed between November 2023 and March 2024 through professional networks and social media. Questions addressed surgeon demographics, perioperative strategies, and technical approaches to rectopexy. Responses were analysed descriptively and stratified by region and specialty.<h4>Results</h4>A total of 226 surgeons from 36 countries across four continents completed the survey. Most respondents (79.6%) administered preoperative intravenous antibiotics, and 80.5% used some form of mechanical bowel preparation. Minimally invasive approaches predominated (81%), with laparoscopy being most common. Posterior dissection was preferred by 61.5%, while 38.5% favoured ventral (anterior) dissection. Two-thirds (68.1%) routinely used mesh, predominantly synthetic. Only 15% performed rectopexy as a day-case procedure. Regional and specialty-related variations were evident in approach, mesh type, and perioperative protocols.<h4>Conclusion</h4>This international survey reveals marked variability in rectopexy practice worldwide. Despite common principles, surgeon preference and regional factors strongly influence decision-making. The findings emphasise the need for updated international guidelines to harmonise technique selection and perioperative management in rectal prolapse surgery.
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Search related cases →Original publication on Europe PMC: https://europepmc.org/article/MED/41486360