Techniques in coloproctology - controversies in coloproctology resection: rectopexy is an underutilised procedure in the management of both symptomatic high-grade internal and external rectal prolapse.

UNLABELLED: Herein the authors discuss their approach of using resection rectopexy to select cases of external and high grade internal rectal prolapse resistant to conservative therapy. They describe a scientific, anatomical and physiological approach to this complex clinical problem. They present a methodical framework based on the latest scientific understanding, but also the importance of tailoring this to individual patients. The authors describe, for the first time in the literature, different clinical phenotypes of prolapse that they have identified and include a high quality surgical video demostrating their technique in three different phenotypic cases.

SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s10151-025-03239-8.