Rectopexy According to Frykman-Goldberg Technique

  • Gian Gaetano Delaini
  • Gianluca Colucci


Rectal prolapse is defined as a full-thickness protrusion of the rectal wall through the anus that is also called procidentia. This disease has plagued human beings throughout history, as it was first described in the Eber papyrus (1500 BC). Hippocrates proposed the first treatment for rectal prolapse by hanging the patient upside down and vigourously shaking him [1]. It is extremely difficult to report the real incidence of this condition, as it has been generally underestimated. The risk factors, as described by Vongsangnak et al. [2], are chronic straining (due to long-standing constipation), prior surgery, neurological and mental illness and ageing. Even if in the past the disease was described as a condition especially affecting young men (as it seems to still be in developing countries), the female to male ratio is now 10:1 [3].


Pelvic Floor Pelvic Organ Prolapse Rectal Prolapse Pelvic Organ Prolapse Surgery Complete Rectal Prolapse 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Pemberton J, Swash M, Henry MM (2002) The pelvic floor: its function and disorder. W.B. Sauders, PhiladelphiaGoogle Scholar
  2. 2.
    Vongsangnak V, Varma JS, Smith AN (1985) Reappraisal of Thiersch’s operation for complete rectal prolapse. J R Coll Surg Edinb 30:185–187PubMedGoogle Scholar
  3. 3.
    Watts JD, Rothenberger DA, Buls JG et al (1985) The management of procidentia. 30 years’ experience. Dis Colon Rectum 28:96–102PubMedCrossRefGoogle Scholar
  4. 4.
    Neill ME, Parks AG, Swash M (1981) Physiological studies of the anal sphincter musculature in faecal incontinence and rectal prolapse. Br J Surg 68:531–536PubMedCrossRefGoogle Scholar
  5. 5.
    von Eiselsberg F (1902) Zur operativen behandlung grosser rectum-prolapse. Arch f Klin Chir 745Google Scholar
  6. 6.
    Moschcowitz A (1912) The pathogenesis, anatomy and care of prolapse of rectum. Surg Gynecol Obstet 15:7Google Scholar
  7. 7.
    Pemberton JD, Stalker LK (1939) Surgical treatment of complete rectal prolapse. Ann Surg 109:799–808PubMedCrossRefGoogle Scholar
  8. 8.
    Graham W, Clegg JF, Taylor V (1984) Complete rectal prolapse: repair by a simple technique. Ann R Coll Surg Engl 66:87–89PubMedGoogle Scholar
  9. 9.
    Bacon HE, Burkett W, Sauer J (1950) Surgical management of rectal procidentia. South Surgeon 11:15Google Scholar
  10. 10.
    Hayden E (1947) Prolapse of the rectum. S Clin North Am 27:1062Google Scholar
  11. 11.
    Stabins SJ (1951) A new surgical procedure for complete rectal prolapse in the mentally ill patient; case report. Surgery 29:105–108PubMedGoogle Scholar
  12. 12.
    Frykman HM (1955) Abdominal proctopexy and primary sigmoid resection for rectal procidentia. Am J Surg 90:780–789PubMedCrossRefGoogle Scholar
  13. 13.
    Frykman HM, Goldberg SM (1969) The surgical treatment of rectal procidentia. Surg Gynecol Obstet 129:1225–1230PubMedGoogle Scholar
  14. 14.
    Senagore AJ, Luchtefeld MA, Mackeigan JM, Mazier WP (1993) Open colectomy versus laparoscopic colectomy: are there differences? Am Surg 59:549–553PubMedGoogle Scholar
  15. 15.
    Sackier JM, Berci G, Hiatt JR, Hartunian S (1992) Laparoscopic abdominoperineal resection of the rectum. Br J Surg 79:1207–1208PubMedCrossRefGoogle Scholar
  16. 16.
    Ballantyne GH (1992) Laparoscopically assisted anterior resection for rectal prolapse. Surg Laparosc Endosc 2:230–236PubMedGoogle Scholar
  17. 17.
    Baker R, Senagore AJ, Luchtefeld MA (1995) Laparoscopic-assisted vs. open resection. Rectopexy offers excellent results. Dis Colon Rectum 38:199–201PubMedCrossRefGoogle Scholar
  18. 18.
    Johnson E, Stangeland A, Johannessen HO, Carlsen E (2007) Resection rectopexy for external rectal prolapse reduces constipation and anal incontinence. Scand J Surg 96:56–61PubMedGoogle Scholar
  19. 19.
    Guenaga K, Atallah AN, Castro AA et al (2005) Mechanical bowel preparation for elective colorectal surgery. Cochrane Database Syst Rev (1):CD001544Google Scholar
  20. 20.
    Heald R, Husband E, Rayall R (1982) The mesorectum in rectal cancer surgery — the clue to pelvic recurrence? Br J Surg 69:613–619PubMedCrossRefGoogle Scholar
  21. 21.
    Novara G, Galfano A, Secco S (2007) Prolapse surgery: an update. Curr Opin Urol 17:237–241PubMedCrossRefGoogle Scholar
  22. 22.
    Ayav A, Bresler L, Hubert J et al (2005) Robotic-assisted pelvic organ prolapse surgery. Surg Endosc 19:1200–1203PubMedCrossRefGoogle Scholar
  23. 23.
    Ayav A, Bresler L, Brunaud L, Boissel P (2004) Early results of one-year robotic surgery using the Da Vinci system to perform advanced laparoscopic procedures. J Gastrointest Surg 8:720–726PubMedCrossRefGoogle Scholar
  24. 24.
    Munz Y, Moorthy K, Kudchadkar R et al (2004) Robotic assisted rectopexy. Am J Surg 187:88–92PubMedCrossRefGoogle Scholar
  25. 25.
    Heemskerk J, de Hoog DE, van Gemert WG et al (2007) Robot-assisted vs. conventional laparoscopic rectopexy for rectal prolapse: a comparative study on costs and time. Dis Colon Rectum (E-pub ahead of print)Google Scholar
  26. 26.
    Kim DS, Tsang CB, Wong WD (1999) Complete rectal prolapse: evolution of management and results. Dis Colon Rectum 42:460–466PubMedCrossRefGoogle Scholar
  27. 27.
    DiGiuro G, Ignjatovic D, Brogger J, Bergamaschi R (2006) How accurate are published recurrence rates after rectal prolapse surgery? A meta-analysis of individual patient data. Am J Surg 191:773–778PubMedCrossRefGoogle Scholar
  28. 28.
    Husa A, Sainio P, von S K (1988) Abdominal rectopexy and sigmoid resection (Frykman-Goldberg operation) for rectal prolapse. Acta Chir Scand 154:221–224PubMedGoogle Scholar
  29. 29.
    Delaney CP (2007) Laparoscopic management of rectal prolapse. J Gastrointest Surg 11:150–152PubMedCrossRefGoogle Scholar
  30. 30.
    Kellokumpu IH, Vironen J, Scheinin T (2000) Laparoscopic repair of rectal prolapse: a prospective study evaluating surgical outcome and changes in symptoms and bowel function. Surg Endosc 14:634–640PubMedCrossRefGoogle Scholar
  31. 31.
    Gurlich R, Sixta B, Drastich P et al [Laparoscopic rectopexis]. Rozhl Chir 85:233–235Google Scholar
  32. 32.
    Kariv Y, Delaney CP, Casillas S et al (2006) Long-term outcome after laparoscopic and open surgery for rectal prolapse: a case-control study. Surg Endosc 20:35–42PubMedCrossRefGoogle Scholar
  33. 33.
    Sezai D, Demirbas S, Akin L (2005) The impact of laparoscopic resection rectopexy in patients with total rectal prolapse. Mil Med 170:743–747PubMedGoogle Scholar
  34. 34.
    Gourgiotis S, Baratsis S (2007) Rectal prolapse. Int J Colorectal Dis 22:231–243PubMedCrossRefGoogle Scholar
  35. 35.
    Marderstein EL, Delaney CP (2007) Surgical management of rectal prolapse. Nat Clin Pract Gastroenterol Hepatol 4:552–561PubMedCrossRefGoogle Scholar
  36. 36.
    Sailer M, Bonicke L, Petersen S (2007) [Surgical options in the treatment of rectal prolapse: indications, techniques and results]. Zentralbl Chir 132:350–357PubMedCrossRefGoogle Scholar
  37. 37.
    Stein EA, Stein DE (2006) Rectal procidentia: diagnosis and management. Gastrointest Endosc Clin N Am 16:189–201PubMedCrossRefGoogle Scholar
  38. 38.
    Munoz F, del Valle E, Rodriguez M, Zorrilla J (2005) [Rectal prolapse. Abdominal or perineal approach? Current situation]. Cir Esp 78(Suppl 3):50–58PubMedCrossRefGoogle Scholar
  39. 39.
    Lechaux D, Trebuchet G, Siproudhis L, Campion JP (2005) Laparoscopic rectopexy for full-thickness rectal prolapse: a single-institution retrospective study evaluating surgical outcome. Surg Endosc 19:514–518PubMedCrossRefGoogle Scholar
  40. 40.
    Chiu HH, Chen JB, Wang HM (2001) Surgical treatment for rectal prolapse. Zhonghua Yi Xue Za Zhi (Taipei) 64:95–100PubMedGoogle Scholar
  41. 41.
    Kellokumpu IH, Kairaluoma M (2001) Laparoscopic repair of rectal prolapse: surgical technique. Ann Chir Gynaecol 90:66–69PubMedGoogle Scholar
  42. 42.
    Madoff RD, Mellgren A (1999) One hundred years of rectal prolapse surgery. Dis Colon Rectum 42:441–450PubMedCrossRefGoogle Scholar
  43. 43.
    Stevenson AR, Stitz RW, Lumley JW (1998) Laparoscopic-assisted resection-rectopexy for rectal prolapse: early and medium follow-up. Dis Colon Rectum 41:46–54PubMedCrossRefGoogle Scholar
  44. 44.
    Hool GR, Hull TL, Fazio VW (1997) Surgical treatment of recurrent complete rectal prolapse: a thirtyyear experience. Dis Colon Rectum 40:270–272PubMedCrossRefGoogle Scholar
  45. 45.
    Jacobs LK, Lin YJ, Orkin BA (1997) The best operation for rectal prolapse. Surg Clin North Am 77:49–70PubMedCrossRefGoogle Scholar
  46. 46.
    Penninckx F, D’Hoore A, Sohier S, Kerremans R (1997) Abdominal resection rectopexy versus Delorme’s procedure for rectal prolapse: a predictable outcome. Int J Colorectal Dis 12:49–50PubMedCrossRefGoogle Scholar
  47. 47.
    Kockerling F, Schneider C, Hohenberger W (1996) [Rectal prolapse—choice of procedure and minimally invasive possibilities]. Chirurg 67:471–482PubMedGoogle Scholar
  48. 48.
    Carpelan-Holmstrom M, Kruuna O, Scheinin T (2006) Laparoscopic rectal prolapse surgery combined with short hospital stay is safe in elderly and debilitated patients. Surg Endosc 20:1353–1359PubMedCrossRefGoogle Scholar
  49. 49.
    Gaivoronskaia SS, Vasil’ev SV, Chaniia ZD et al (2007) [Potentialities of complex treatment of prolapse of the rectum]. Vestn Khir Im I I Grek 166:100–102PubMedGoogle Scholar
  50. 50.
    Steele SR, Goetz LH, Minami S et al (2006) Management of recurrent rectal prolapse: surgical approach influences outcome. Dis Colon Rectum 49:440–455PubMedCrossRefGoogle Scholar
  51. 51.
    Verdaasdonk EG, Bueno de Mesquita JM, Stassen LP (2006) Laparoscopic rectovaginopexy for rectal prolapse. Tech Coloproctol 10:318–222PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Italia 2008

Authors and Affiliations

  • Gian Gaetano Delaini
    • 1
  • Gianluca Colucci
    • 1
  1. 1.Department of Surgery and GastroenterologyUniversity of VeronaVeronaItaly

Personalised recommendations