Laparoscopic modified mesh rectopexy: medium‐term results of a novel approach for external rectal prolapse

Aim Rectal prolapse is a common and significantly debilitating condition. Surgical correction is usually required. The two most common abdominal approaches are ventral mesh rectopexy and posterior suture rectopexy. Both may be complicated, respectively, by either mesh‐related complications or signif...

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Bibliographic Details
Published inColorectal disease Vol. 25; no. 12; pp. 2378 - 2382
Main Authors Thomas, G. P., Wong, F., Vaizey, C. J., Warusavitarne, J. H.
Format Journal Article
LanguageEnglish
Published England Wiley Subscription Services, Inc 01.12.2023
Subjects
Aged
Complications
Constipation
Constipation - etiology
Constipation - surgery
Female
Humans
laparoscopic
Laparoscopy
Laparoscopy - methods
Male
Postoperative
prolapse
Quality of Life
rectal prolapse
Rectal Prolapse - complications
rectopexy
Rectum
Rectum - surgery
Recurrence
Sacrum
Surgical Mesh - adverse effects
Sutures
Treatment Outcome
laparoscopic
rectopexy
prolapse
rectal prolapse
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Summary:Aim Rectal prolapse is a common and significantly debilitating condition. Surgical correction is usually required. The two most common abdominal approaches are ventral mesh rectopexy and posterior suture rectopexy. Both may be complicated, respectively, by either mesh‐related complications or significant postoperative constipation. We report the outcome of a novel rectopexy operation which combines aspects of both the aforementioned approaches, for the treatment of external rectal prolapse (ERP). Method The technique involves laparoscopic partial posterior‐lateral rectal mobilization of the rectum with posterior suture fixation to the sacral promontory and placement of an absorbable mesh in the rectovaginal space. Data were collected on postoperative complications, prolapse recurrence, mesh‐related complications and the assessment of quality of life. Results Eighty patients underwent a modified mesh rectopexy for ERP. Seventy‐seven were women. The median age was 67.5 years. Almost a third had undergone a previous rectal prolapse repair. Recurrences were seen in 11 (13.8%). No mesh‐related complications were seen. Eleven patients reported postoperative constipation. Conclusion The laparoscopic modified mesh rectopexy may be a safe and effective operation for the treatment of ERP.
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ISSN:1462-8910
1463-1318
DOI:10.1111/codi.16804