# Surgeon preferences and practice patterns in rectopexy: Results of an international survey **Authors:** Eleftherios Gialamas, Isabelle Uhe, Pierre‐Alain Tokoto, Emilie Liot, Frédéric Ris, Steven D. Wexner, Jeremy Meyer, Guillaume Meurette, Abdulahad Al‐Ameri, Abdulahad Al‐Ameri, Adam Mylonakis, Ahmed Abdelsamad, Aakansha Giri Goswami, Al Marazgh Mohammad, Alberto Aiolfi, Alessia Fassari, Angelo Alessandro Marra, Alessandro Garcea, Alexandra Menni, Alexandra Winter, Alexandros Chamzin, Alexandros Kozadinos, Alice Frontali, Amine Gouader, Amine Souadka, Amanda Pereira Lima, Andrea Balla, Andrea Peloso, Andrea Pierre Luzzi, Andreas Panagakis, Andrei Chitul, Andrei Popa, Angelo Stuto, Angeliki Vouchara, Antonio Castaldi, Antonio Luberto, Arcangelo Picciariello, Argyrios Ioannidis, Augustinas Bausys, Audrius Dulskas, Baljit Singh, Benjamin Fernandez, Boris Schiltz, Bruno Perotti, Bruno Roche, Brunella M. Pirozzi, Carlos Augusto Gomes, Carmen Gorgan, Céline Duvoisin Cordoba, Charles Sabbagh, Christina A. Fleming, Christos Barkolias, Christos Chouliaras, Christoph Werner Strey, Claudio Soravia, Cosimo R. Scarpa, Dan‐Eduard Giuvara, Danilo Vinci, David Alessio Merlini, David D.E. Zimmerman, Debby Keller, Deiro Giacomo, Dieter Hahnloser, Diletta Corallino, Dimitris Korkolis, Dimitrios Linardoutsos, Dimitrios Moris, Dimitrios Schizas, Eleandros Kyros, Elisa Reitano, Elissavet Anestiadou, Emanuela Silva Alvarenga, Eric G. Weiss, Fabio Carbone, Federica Di Marco, Filippo Carannante, Flaviu Ionut Faur, Floryn Cherbanyk, Francesco Ferrara, Francesco Pata, Gaetano Florio, Gabriele Naldini, Gabriele Pozzo, Gabriella Teresa Capolupo, Giacomo Ambrogi, Giacomo Calini, Gianluca Pellino, Gianpiero Gravante, Giovanna Dasilva, Giovanni Cestaro, Giovanni Tebala, Giovanni Tomasicchio, Giuseppe Brisinda, Giuseppe Candilio, Giuseppe Giuliani, Goran Barisic, Goytom Knfe, George Stavrou, Georgios Korovesis, Georgios Peros, Georgios Tzikos, Gustavo Nari, Harish Neelamraju Lakshmi, Hemendra Kumar Mangal, Hugh M. Paterson, Ibrahim Burak Bahçecioğlu, Ibrahim Ethem Gecim, İlgar Ismayilov, Ioannis Katsaros, Jasper Stijns, Jelenko Jelenkovic, Jin Jiun Mah, Justin Davies, Kashish Malhotra, Klaus Peitgen, Konstantinos Tsimogiannis, Konstantinos Zarras, Lars Thomas Seeberg, Leandro Siragusa, Lorenzo Epis, Lucio Taglietti, Lysandros Karydakis, Maria Chiara Ranucci, Maria Sotiropoulou, Mark Potter, Marko Miladinov, Martin Bertrand, Matteo Santoliquido, Mhairi Collie, Michel Adamina, Michaela Ramser, Michaël Racine, Michail Vailas, Mohamed Ali Chaouch, Mohd. Azharuddin Attar, Mostafa Shalaby, Muhammad Rafaih Iqbal, Muhammad Umar Younis, Mustafa Yener Uzunoglu, Niels Komen, Nicola Colucci, Nicolas C. Buchs, Nir Horesh, Noam Shussman, Nora Abbesorabi, Nuri Okkabaz, Omer Yalkin, Orestis Ioannidis, Paolo Ossola, Paolo Panaccio, Patricia Tejedor, Pedro Botelho, Pietro Fransvea, Pim B. Olthof, Pravin Meenashi Sundaram, Priscila Tanuri, Prokopis Christodoulou, Raffaele Galli, Raja Basit Khan, Rémy Kohler, Renan Colombari, Rogier Crolla, Sarah Vogler, Saulius Mikalauskas, Sameh Emile, Sergio Agradi, Sergio Larach, Sevket Baris Morkavuk, Simone Manfredelli, Spyridon Davakis, Stefano Gussago, Stefano Olmi, Stephan Bischofberger, Suman Baral, Syed Muhammad Ali, Tahar Fillali, Valentin Calu, Valentina Miacci, Venkatesh Munikrishnan, Vittoria Bellato, Vusal Aliyev, William Perry, Xenofon Papazarkadas, Yasuko Maeda PMC · DOI: 10.1111/codi.70355 · 2026-01-04 ## TL;DR This study surveyed surgeons globally to understand variations in rectopexy techniques for rectal prolapse, finding significant differences influenced by personal and regional preferences. ## Contribution The paper provides the first international survey on rectopexy practices, highlighting variability and the need for updated guidelines. ## Key findings - Most surgeons use minimally invasive approaches, with laparoscopy being the most common. - There is significant regional variation in dissection techniques and mesh usage. - Only a small percentage perform rectopexy as a day-case procedure. ## Abstract 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. 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. 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. 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. ## Linked entities - **Diseases:** rectal prolapse (MONDO:0004754) ## Full-text entities - **Diseases:** rectal prolapse (MESH:D012005), prolapse (MESH:D011391) ## Figures 1 figure with captions in the complete paper: https://tomesphere.com/paper/PMC12765771/full.md --- Source: https://tomesphere.com/paper/PMC12765771