Laparoscopic Rectal Prolapse Surgery - Procedure & Recovery

Prolapse is when any body part slips or falls down from its normal position.

Rectal prolapse is when your rectum -- the last section of your large intestine slides out or comes of your anus

1. For most people, rectal prolapse surgery relieves symptoms and improves faecal incontinence and constipation.
2. In some cases, constipation can worsen or become a problem when it wasn't one before surgery.

The main objective of performing laparoscopic rectal prolapse surgery is to reduce the pain and other symptoms like:-

1. A feeling of pain and discomfort in the region of the lower abdomen
2. Leaking of mucus and blood from the anus
3. Difficulty in passing the stool
4. Feeling of constipation
5. Feeling like the rectum is not completely emptied after passing stool.
6. Reduced ability to control bowel movement
7. Pain in rectum or in anus.

What will happen if surgery is delayed? 

1.  If the laparoscopic rectal prolapse surgery is delayed, it can lead to the following types of complications.
2. Damage to the rectum.
3. Ulcers may be formed in the rectum.
4. Unable to push the rectum manually back inside the body.
5. Reduction of blood supply in the rectal part
6. Gangrene (tissue death due to the lack of blood flow

Procedure

The procedure of laparoscopic rectal prolapse surgery.

Generally, laparoscopic rectal prolapse surgery is done in three steps. They are:-

Step 1: 

1. The surgeon makes a minor cut of about half a centimetre near the belly button. 
2. A laparoscope (a thin tube having a camera and light at its tip) is then inserted into the abdominal cavity through this cut. Images taken by laparoscope are transferred on the monitor.
3. Then the surgeon will make several minor cuts into the abdomen. Long thin instruments are then inserted into the abdomen through those cuts.

Step 2: 

Your surgeon will locate the rectum and then lift it to its original position in the pelvic region.

Step 3: 

1. Then the rectum is fixed there using stitches. The surgeon may also use the mesh to support the rectum.
2. In some cases, the surgeons remove a part of the sigmoid colon.
3. At last, the pelvis is rinsed, and after this, the stitches will be closed. 
4. In most cases, the stitches are self-dissolving and are under the skin. So, there is no requirement for removing the stitches after the surgery.
5.  The doctor performs the surgery through different approaches. in one approach, the surgeon creates a small incision in the abdomen, and the rectum is pulled back through the incision. in another approach, the surgeon creates several small holes and repairs the rectal prolapse. A different approach is used in patients who may not undergo open or laparoscopic procedures. In this method, the surgeon repairs the rectal prolapse through the anus.

What to expect before laparoscopic rectal prolapse surgery. 

1. The anesthesiologist will visit you in the hospital and examine you to ensure the best anaesthesia.
2. Before surgery, you may receive some medication to prepare for anaesthesia to make you feel drowsy.
3. The doctor may advise you to stop taking medicines like blood thinners and ibuprofen before surgery.
4. Try to avoid smoking.
5. If you are not feeling well before the surgery, then tell your doctor before surgery.
6. The doctor may ask to go for some tests like:-
7. Colonoscopy: The doctor inserts a long tube with a camera into the rectum for examining rectum.
8. Your doctor might do a rectal exam.
9. An intravenous line will be attached to your arm. After that, you will be wheeled into the operation theatre.
10. What to expect on the day of laparoscopic rectal prolapse surgery. 9
11. Be sure to reach the hospital on time.
12. Take the medicines prescribed by your doctor with a small sip of water.
13. After entering the premises, you will have to fill out a consent form and permission for the surgery and anaesthesia. 
14. Wear loose-fitting clothes to the hospital that will be comfortable to wear after the surgery.
15. Leave all your wearables and valuables at your home. Also, do not wear any perfume or body spray.
16. Do not wear contact lenses on the day of surgery.
17. The staff will ask you to change into the hospital gown, cap and paper slippers before preparing for the operation.
18. Then they will put an ID bracelet around your wrist.
19. The staff will ask your name and date of birth for confirming the patient.
20. What to expect during surgery? 10, 11
21. An anesthesiologist will inject a precise dose of anaesthesia into the patient. 
22. Since all the procedure of surgery is done under the influence of anaesthesia, you will not feel any pain.
23. Then, a thin pipe will be inserted into the throat of the patient. It is done to facilitate breathing during surgery.
24. It involves inserting slender instruments through some holes into the abdominal cavity.
25. Rectal prolapse is corrected by using special surgical tools and a tiny camera.
26. During the whole procedure, all the vital signs like blood pressure, pulse rate and heartbeat are under the supervision of the staff.

What to expect on the day of laparoscopic rectal prolapse surgery. ?

1. Be sure to reach the hospital on time.
2. Take the medicines prescribed by your doctor with a small sip of water.
3. After entering the premises, you will have to fill out a consent form and permission for the surgery and anaesthesia. 
4. Wear loose-fitting clothes to the hospital that will be comfortable to wear after the surgery.
5. Leave all your wearables and valuables at your home. Also, do not wear any perfume or body spray.
6. Do not wear contact lenses on the day of surgery.
7. The staff will ask you to change into the hospital gown, cap and paper slippers before preparing for the operation.
8. Then they will put an ID bracelet around your wrist.
9. The staff will ask your name and date of birth for confirming the patient.

What to expect during surgery? 

1. An anesthesiologist will inject a precise dose of anaesthesia into the patient. 
2. Since all the procedure of surgery is done under the influence of anaesthesia, you will not feel any pain.
3. Then, a thin pipe will be inserted into the throat of the patient. It is done to facilitate breathing during surgery.
4. It involves inserting slender instruments through some holes into the abdominal cavity.
5. Rectal prolapse is corrected by using special surgical tools and a tiny camera.
6. During the whole procedure, all the vital signs like blood pressure, pulse rate and heartbeat are under the supervision of the staff.

What to expect after surgery? 

1. After completing the surgery, you are likely to spend a short time in hospital. This period is for regaining the bowel movements.
2. Your surgeon might recommend drinking a lot of fluids, intaking fibres and using stool softeners. These things are advised to prevent constipation and excessive straining after the surgery because this can again lead to rectal prolapse.
3. The patient is given pain medications to control the pain caused after surgery.
4. After the surgery, walking is considered a great exercise. It helps in healing by increasing the muscle's strength.

First follow-up appointment

1. The doctor will give you a date for a follow-up visit during your discharge from the hospital.
2. Do not miss the follow-up visit, and do not forget to take all the medical records related to the surgery.
3. Your doctor may query your overall health and any symptoms of concern you are experiencing. 
4. During the follow-up visit, some medications, such as analgesics and antibiotics, may be discontinued, or their dose may be reduced.
5. You may also seek information about your recovery, recurrence of the prolapse, and resuming various activities and timelines.

You must consult your Doctor , if you are experiencing any of the following symptoms:-

1. Necrosis of the rectal wall.
2. Rectal prolapse occurs again after surgery.
3. Infection.
4. Haemorrhage (Bleeding).
5. Damage to other organs in the pelvic region like the Bladder or rectum.
6. Leakage of stool from the colon
7. Hernia.
8. Diarrhoea.