Robot-assisted rectopexy and colpopexy for rectal prolapse

This video demonstrates a technique for robot-assisted combined rectopexy with colpopexy, but without the use of mesh for rectal prolapse.

This case features a 61-year-old woman who presents with complaints of tissue protruding through her rectum and fecal incontinence. On examination, she was found to have circumferential, full-thickness rectal prolapse and perineal descent. We present a technique that combines rectopexy with colpopexy without the use of mesh for repair of rectal prolapse. Postoperative examination revealed resolution of rectal prolapse and good perineal support. This video illustrates a technique that may serve as a useful adjunct to have in one’s surgical armamentarium in circumstances when mesh should not or cannot be used, such as in cases that require resection of the sigmoid colon or for patients who simply prefer to avoid the use of mesh.

Given that rectal prolapse and posthysterecomy vaginal vault prolapse often occur together, our institution routinely performs colpopexy with rectopexy for rectal prolapse to provide additional support to the pelvic floor as demonstrated in this video.