Long-term outcome of laparoscopic rectopexy for full-thickness rectal prolapse

In search of the optimal operation for rectal prolapse: the saga continues…

“…Of course, besides the primary outcome of recurrence of rectal prolapse, anorectal function is another important outcome to monitor. I agree with the authors that "patients with recurrence may have an inherent tissue weakness and chronic pelvic floor laxity which contribute to recurrence" [3]. Furthermore, this "inherent tissue weakness and chronic pelvic floor laxity" is not specifically addressed by any of the abdominal operations previously described for rectal prolapse, including the authors preferred approach (i.e., posterior suture rectopexy) or the ventral mesh rectopexy they performed for recurrent cases, which lead to a high failure rate in this patient population.…”

“…The retrospective review of de Bruijn and associates from St. Mark's, "Long-term outcome of laparoscopic rectopexy for full-thickness rectal prolapse" presents their experience with laparoscopic suspension procedures (90% posterior suture rectopexy) to correct rectal prolapse in 80 patients from 2006 to 2014, with 'long-term' follow-up defined as greater than 12 months [3]. The authors should be commended for their persistence in tracking down these patients and their honesty in reporting the long-term recurrence rate of rectal prolapse.…”

Restored pelvic anatomy is preserved after laparoscopic and robot‐assisted ventral rectopexy: MRI‐based 5‐year follow‐up of a randomized controlled trial

“…Therefore, dynamic MRI is useful in the evaluation of the therapeutic outcome [25,26]; in addition, when evaluating posterior compartment prolapse, the evacuation phase needs to be included [28]. Since the site of POP can be misdiagnosed by clinical examination in 45–90% of cases [28], and because more than half of IRPs may be missed [3], the use of imaging in our study provided a more accurate assessment of the operative outcomes and possible recurrence of prolapse after VMR than prospective or retrospective series have provided thus far [29–31]. Indeed, we also found that support to the posterior vaginal wall in clinical examination was well maintained and constant in all patients in both study groups; however, MR defaecography revealed IRP in 15% (4/26) of the study patients.…”

What is the recommended procedure for recurrent rectal prolapse? A retrospective cohort study in a single Japanese institution

“…The presence or absence of new recurrence was the dependent variable. In contrast, seven clinical variables, including sex, age [9], presence or absence of pelvic organ prolapse including uterine, vaginal, and bladder prolapse [10], number of surgical repairs previously underwent for RP [7], type of surgical repair previously underwent for RP (transabdominal vs. perineal approach), length of recurrent RP, and type of surgical approach for recurrent RP (lap-rectopexy vs. perineal approach) [1] were used as independent variables. This retrospective cohort study was approved by the Toho University Omori Medical Center Ethics Committee (No.…”

“…Recently, laparoscopic techniques have been added as treatment options for RP because of their advantages of early recovery, less pain, and the possibility of lower morbidity. Some researchers have reported that laparoscopic procedures represent a new surgical approach as an alternative to conventional abdominal procedures [3][4][5][6][7][8].…”