Laparoscopic Posterior Mesh Rectopexy Vs Laparoscopic Suture Rectopexy for Complete Rectal Prolapse: A Randomized Controlled Trial

Laparoscopic Mesh vs Suture Rectopexy for Rectal Prolapse

Abstract

Background: Complete rectal prolapse refers to the full-thickness extension of the rectal wall through the anus and is more prevalent in older adults, particularly women. Treatment primarily includes surgical correction, and there is still a discussion regarding the most effective one. Objective: This paper compares two laparoscopic methods, including laparoscopic posterior mesh rectopexy (LPMR) and laparoscopic posterior suture rectopexy (LPSR), in terms of recurrence rates and bowel functioning outcomes. Study Design: Randomized controlled trial. Settings: Department of Surgery, Khyber Teaching Hospital, Peshawar Pakistan. Duration: two years from December 2023 to November 2025. Methods: A total of seventy-seven patients were selected who had complete rectal prolapse at random to receive either LPMR or LPSR. Outcomes were recurrence, postoperative constipation scores, and fecal incontinence severity index (FISI) at 30 and 60 days in the postoperative period. Results: Both groups were demographically similar. The LPMR group had significantly lower recurrence rates (p = 0.004), shorter operative time (p < 0.001), and improved bowel function, demonstrated by lower constipation (p < 0.001) and FISI scores (p = 0.001). No significant differences were observed in postoperative pain, hospital stay, or intraoperative blood loss. Conclusion: LPMR appears to offer superior outcomes over LPSR in reducing prolapse recurrence and improving bowel function. Long-term follow-up is recommended to assess the durability and safety of mesh use.