We describe the case of a 77 year old female with a history of rectal prolapse, rectocele and sigmoidocele, and obstructive defecation. Clinically, her rectal prolapse had a posterior leading edge. We decided to use an anterior and posterior approach to repair her prolapse with synthetic mesh using the da vinci robotic platform. We describe the rectal dissection, identification of the vaginal cuff in a patient who is status post hysterectomy, and anterior and posterior polypropylene mesh fixation. At one year follow up the patient has not experienced any recurrent symptoms of obstructive defecation or rectal prolapse.