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. 2026 Jan;28(1):e70355.
doi: 10.1111/codi.70355.

Surgeon preferences and practice patterns in rectopexy: Results of an international survey

Eleftherios Gialamas  1   2 , Isabelle Uhe  1   2 , Pierre-Alain Tokoto  1   2 , Emilie Liot  1   2 , Frédéric Ris  1   2 , Steven D Wexner  3 , Jeremy Meyer  1   2 , Guillaume Meurette  1   2 ; International Rectopexy Collaborative Group
Collaborators, Affiliations

Surgeon preferences and practice patterns in rectopexy: Results of an international survey

Eleftherios Gialamas et al. Colorectal Dis. 2026 Jan.

Abstract

Aim: Rectopexy is the preferred abdominal intervention for rectal prolapse. Despite similar procedural steps - rectal mobilisation, prolapse reduction, and fixation - techniques vary widely, and onsensus on the optimal approach is lacking. This study aimed to assess global surgeon preferences and practices in rectopexy.

Methods: An international 28-item online survey was distributed between November 2023 and March 2024 through professional networks and social media. Questions addressed surgeon demographics, perioperative strategies, and technical approaches to rectopexy. Responses were analysed descriptively and stratified by region and specialty.

Results: A total of 226 surgeons from 36 countries across four continents completed the survey. Most respondents (79.6%) administered preoperative intravenous antibiotics, and 80.5% used some form of mechanical bowel preparation. Minimally invasive approaches predominated (81%), with laparoscopy being most common. Posterior dissection was preferred by 61.5%, while 38.5% favoured ventral (anterior) dissection. Two-thirds (68.1%) routinely used mesh, predominantly synthetic. Only 15% performed rectopexy as a day-case procedure. Regional and specialty-related variations were evident in approach, mesh type, and perioperative protocols.

Conclusion: This international survey reveals marked variability in rectopexy practice worldwide. Despite common principles, surgeon preference and regional factors strongly influence decision-making. The findings emphasise the need for updated international guidelines to harmonise technique selection and perioperative management in rectal prolapse surgery.

Keywords: rectal prolapse; rectopexy; surgeon's preference; survey.

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Conflict of interest statement

The authors have no conflict of interest to disclose.

Figures

FIGURE 1
FIGURE 1
Global distribution of respondents by country (Choropleth map illustrating the number of participating surgeons per country. Darker shading corresponds to higher respondent numbers (range 1–60), while countries in grey had no participants).
See this image and copyright information in PMC

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