Laparoscopic ventral rectopexy for external rectal prolapse improves constipation and avoids de novo constipation

Abstract

Ventral rectopexy has a recurrent prolapse rate of < 5%, similar to that of posterior rectopexy. Its correction of preoperative constipation and avoidance of de novo constipation appear superior to historical functional results of posterior rectopexy. A laparoscopic approach allows low morbidity and short hospital stay, even in those patients over 80 years of age in whom a perineal approach is usually preferred for safety.

Laparoscopic ventral rectopexy using biologic mesh for the treatment of obstructed defaecation syndrome and/or faecal incontinence in patients with internal rectal prolapse: a critical appraisal of the first 100 cases

“…Nevertheless, the post-operative mean hospital stay in our study was only 2 days, comparable with that reported by experienced centres [2,4,12].…”

“…Wijffels et al [3,12,[23][24][25][26] demonstrated the safety of this technique for the elderly compared with previously used more extensive procedures for rectal prolapse.…”

“…Proctograms were evaluated using the Oxford Prolapse Grading system (Table 1) [2,12]. Rectoceles were classified as large if C4 cm and perineal descend severe if C7 cm on imaging.…”

The optimal strategy for proximal mesh fixation during laparoscopic ventral rectopexy for rectal prolapse: an ex vivo study

“…In the original articles by D'Hoore et al [6,7], the use of a polypropylene mesh is described, with distal fixation by nonresorbable sutures and proximal fixation by either nonresorbable sutures or an endofascia stapler. Since then, several articles [4,5,[8][9][10] have reported on the results of LVR for both internal and external rectal prolapse. A polypropylene mesh is used in all these studies, and the majority of the studies mention the use of tacks as the proximal mesh fixation technique of choice.…”

Laparoscopic ventral rectopexy in an elderly population with external rectal prolapse: clinical and anal manometric results

“…A few previous studies report that the laparoscopic procedure is effective and safe to perform on elderly debilitated patients [4,5], but often the study populations have mean ages close to 60-70 years [6][7][8], which in this setting may be considered young.…”