Rectal Prolapse

What is it?

Rectal prolapse is a medical condition in which the rectum, the last portion of the large intestine, protrudes outside the anus. This occurs when the rectum turns itself inside out and comes out through the anal opening.

Surgery Dr Golani Rectal Prolapse Repair

Rectal prolapse can vary in severity, and there are different types:

Partial or Mucosal Prolapse (Mucous Prolapse) : In this form, only the inner lining of the rectum protrudes through the anus. It often appears as a reddish or pinkish mass of tissue during bowel movements and may retract back into the anus spontaneously or with manipulation.
Complete Rectal Prolapse : In a complete rectal prolapse, the entire wall of the rectum protrudes through the anus. This is more severe and can be painful. The prolapsed rectum often looks like a reddish mass of tissue hanging outside the body.
Internal Rectal Prolapse (Intussusception) : This type occurs when one part of the rectum folds into itself, much like how a telescope collapses. It may not protrude out of the anus but can cause symptoms like difficulty with bowel movements and a sensation of incomplete emptying.

Rectal prolapse can lead to a range of symptoms, including:

Pain or discomfort in the anal area
Bleeding from the rectum
Constipation or diarrhoea
Mucus discharge from the rectum
A feeling of incomplete emptying after bowel movements

The exact cause of rectal prolapse can vary and may include factors such as weakened pelvic floor muscles, chronic constipation, straining during bowel movements, pregnancy and childbirth, age-related weakening of tissues, and certain medical conditions, such as cystic fibrosis.

Treatment for rectal prolapse depends on its severity and the individual's overall health. Mild cases of partial prolapse may be managed conservatively with dietary changes, stool softeners, and pelvic floor exercises to strengthen the muscles. In more severe cases, or when conservative measures are ineffective, surgical intervention may be necessary to repair or reposition the prolapsed rectum.

A surgical options for treating rectal prolapse include:

Laparoscopic Ventral Mesh Rectopexy
Delorme's Procedure
Altemeier Procedure

Laparoscopic Ventral Mesh Rectopexy (LVMR)

A Laparoscopic Ventral Mesh Rectopexy is an operation used to treat prolapse of the rectum. It is a minimally invasive surgical technique that aims to reposition and secure the rectum, restoring its normal anatomical position within the pelvis. LVMR is performed by colorectal surgeons.

Here's an overview of how laparoscopic ventral mesh rectopexy is typically carried out:

Laparoscopic Approach: LVMR is performed using minimally invasive laparoscopic techniques, which involve making small incisions in the abdominal wall. Through these incisions, a laparoscope (a thin, tube with a camera at the tip) and specialised surgical instruments are inserted.
Visualisation: The surgeon uses the laparoscope to visualize the pelvic area and assess the condition of the rectum, as well as identify any anatomical abnormalities or prolapse.
Rectopexy: During the procedure, the surgeon lifts and repositions the prolapsed rectum to its normal anatomical position within the pelvis.
Support and Reinforcement: This involves attaching the rectum to the back of the sacrum (the triangular bone at the base of the spine) or to nearby tissues using a mesh. The mesh is used to help to prevent future prolapse.
Closure: After the rectopexy and any necessary repairs or reinforcements are completed, the surgical incisions are closed with sutures.

Laparoscopic ventral mesh rectopexy offers several advantages over traditional open surgical approaches:

Minimally Invasive: LVMR involves smaller incisions, which typically results in less post-operative pain, shorter hospital stays, and faster recovery times compared to open surgery.
Precise Visualization: The laparoscope provides clear and magnified images of the surgical field, allowing for precise surgical manoeuvres and a more accurate repositioning of the rectum.
Reduced Risk of Infection: Because the procedure is minimally invasive, there is a lower risk of infection at the surgical site.
Lower Risk of Scarring: The smaller incisions used in laparoscopic surgery result in smaller scars, which can be cosmetically more appealing.
Effective Treatment: LVMR is effective in addressing rectal prolapse and associated conditions, often providing long-term relief from symptoms. 50% of Dr Golani's patients notice improvements in their continence.

However, like all surgical procedures, laparoscopic ventral mesh rectopexy is not without potential risks and complications. The choice of surgical approach and specific techniques used may vary depending on the patient's individual medical history and diagnosis.

Patients considering laparoscopic ventral mesh rectopexy should have a thorough discussion with Dr Golani to weigh the potential benefits and risks. A consultation with Dr Golani will determine if the procedure is the most suitable option for your particular situation.

Delorme's Procedure for Rectal Prolapse

Delorme's procedure is a surgical technique used to treat rectal prolapse, a condition where the rectum protrudes through the anus. This procedure is particularly suited for elderly or high-risk patients due to its less invasive nature.

The Procedure

Preparation: Patients undergo bowel preparation to clear the bowel and fast for several hours before the operation.
Anaesthesia: The surgery is performed under general or spinal anaesthesia.
Surgical Technique:

The mucosa, the inner lining of the prolapsed rectum, is circumferentially excised.
The exposed muscle layer is then folded onto itself like a concertina and sutured to shorten and tighten the rectum.
This folding and suturing correct the prolapse and restore the normal anatomy.

Advantages

Less Invasive: Compared to other procedures, Delorme's is less invasive and can be performed perianally, avoiding abdominal surgery.
Shorter Recovery: Patients typically experience a quicker recovery period.
Suitable for High-Risk Patients: Ideal for patients who may not tolerate more extensive surgery well.

Recovery

Hospital Stay: Usually short, with many patients returning home within a few days.
Postoperative Care: Includes pain management, wound care, avoiding constipation and gradual return to normal activities.
Follow-Up: Regular check-ups to ensure proper healing and function.

Patients considering Delorme's procedure should have a thorough discussion with Dr Golani to weigh the potential benefits and risks.

Altemeier Procedure for Rectal Prolapse

The Altemeier Procedure, also known as perineal rectosigmoidectomy, is a surgical procedure used to correct a full-thickness rectal prolapse.

How Does the Altemeier Procedure Work?

During the Altemeier procedure, Dr Golani will:

Pull the rectum through the anus.
Remove a portion of the rectum and sigmoid colon.
Attach the remaining rectum to the large intestine (colon).

Why Is It Done?

The Altemeier procedure aims to:

Correct rectal prolapse.
Improve defecation and faecal continence.
Enhance the patient's quality of life
Mainly performed in cases of reoccurent Rectal Prolapse

Advantages

The Altemeier Procedure has several advantages:

Simplicity: The Altemeier Procedure is technically less complex than abdominal ones for rectal prolapse.
Low physiological stress: As a perineal procedure, it imposes less physiological stress on patients, making it suitable for older or frailer patients.
Reduced operative time: The procedure typically requires less time in the operating room compared to abdominal approaches.

Patients considering Altemeier's procedure should have a thorough discussion with Dr Golani to weigh the potential benefits and risks.

Your Consultation

Dr. Golani will provide further discussion regarding the specifics of your diagnosis during your consultation. Additionally, you'll have the opportunity to select the hospital for your procedure and potentially set the date for your procedure.

The best surgical hospitals in Sydney are available for your surgery:

To schedule a consultation with Dr. Golani, please contact our team for a consultation with Dr Golani. We have appointments available at three convenient locations across Sydney:

Dr Golani Sydney Clinics - Surgeon General Colorectal

Please note that a GP referral will be required prior to your consultation.

Contact Us

To make an initial consultation booking, please contact our office on 02 8599 9819.

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Hornsby Clinic Address:

Madison Building
Suite 7, 25-29 Hunter St,
Hornsby NSW 2077
Phone: (02) 8599 9819
Email: info@drgolani.com.au
Fax:(02) 9012 0976

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Mater Clinic Address:

Suite 13, Level 1 Mater Clinic
Mater Hospital
25 Rocklands Rd, North Sydney NSW 2060
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Suite 301C, Level 3
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Our Norwest - Bella Vista clinic is located within Q Central Building - opposite Norwest Private Hospital. Free Limited Parking is available within the Q Central Building. There is a drop off zone outside of the building. Paid parking is available opposite at Norwest Private Hospital. Additionally there is parking at Woolworths Norwest Circa (5 minutes walk from the Clinic)
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What do I bring to my appointment?

Referral letter
X-Rays/Scans
Test results relating to referral
Health fund card
Medicare card

Procedures

Dr. Golani offers an extensive range of General and Colorectal Surgical procedures, expertly addressing a diverse array of symptoms, conditions, and diseases. His patient-focused approach ensures personalised care tailored to individual needs.

Bowel Cancer

Dr. Golani delivers exceptional outcomes in laparoscopic resections for both bowel and rectal cancers, combining expertise with advanced surgical techniques to ensure the highest standard of care.

Hernia Surgery

Dr. Golani specialises in hernia repair surgeries, expertly treating ventral hernias as well as performing advanced laparoscopic procedures for inguinal, femoral, and umbilical hernias. His expertise ensures precise and effective care.

Gall Bladder Surgery

Dr. Golani specialises in minimally invasive gall bladder surgery, ensuring faster recovery times and shorter hospital stays with advanced surgical techniques.

Colonoscopy

Dr. Golani is certified by GESA in advanced endoscopic techniques, enabling him to expertly perform colonoscopies and remove large polyps with precision and care.

Rectal Prolapse Surgery

Dr. Golani is an expert in Laparoscopic Ventral Mesh Rectopexy, a highly effective and minimally invasive procedure for rectal prolapse. His advanced skills ensure precise care and improved outcomes for his patients.

Anal Fistulas & Fissures

Dr. Golani offers expert care in managing painful anal fistulas and fissures, providing effective treatments tailored to relieve discomfort and improve quality of life.

Haemorrhoids

Dr. Golani is highly skilled in both traditional and advanced surgical techniques for treating haemorrhoids, offering effective solutions tailored to each patient�s needs.

Gastroscopy & Endoscopy

Dr. Golani is accredited by the Gastroenterological Society of Australia (GESA), ensuring advanced expertise and high standards in performing gastroscopy and endoscopy procedures.