This chapter discusses the case of a 91-year-old woman who was referred to the outpatient clinic with recurrent rectal prolapse following a Delorme's operation 5 years previously. Whilst the recurrent prolapse was initially intermittent, it had become almost permanent and she had virtually no continence. Her past medical history included a knee replacement, hypothyroidism, and eyesight problems. Rectal examination showed a very poor sphincter tone and an obvious external prolapse. The patient underwent flexible sigmoidoscopy which was normal. She went on to have a laparoscopic ventral mesh rectopexy using a three-port technique. Most surgeons in the UK would probably advise a perineal approach for an elderly lady but repeat perineal surgery can be difficult. She made it through abdominal surgery under general anesthesia uneventfully but this was a calculated risk and might have turned out otherwise. The alternative was to leave her alone.