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Lessons learned after more than 400 laparoscopic ventral rectopexies.

B van Geluwe1, A Wolthuis, F Penninckx

  • 1Department of Abdominal Surgery, University Hospital Gasthuisberg, Leuven, Belgium.

Acta Chirurgica Belgica
|June 8, 2013
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Laparoscopic ventral rectopexy (LVR) is a safe and effective treatment for rectal prolapse, offering good functional outcomes. Further optimization of LVR for internal rectal prolapse is suggested.

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Area of Science:

  • Colorectal surgery
  • Minimally invasive procedures
  • Pelvic floor disorders

Background:

  • Laparoscopic ventral rectopexy (LVR) is a nerve-sparing technique for rectal prolapse syndromes.
  • It corrects concomitant rectocele and enterocele by placing mesh in the rectovaginal septum.

Purpose of the Study:

  • To audit the 10-year experience with Laparoscopic ventral rectopexy (LVR).
  • To evaluate the safety, feasibility, and efficacy of LVR for various types of rectal prolapse.

Main Methods:

  • Analysis of demographic, perioperative, and follow-up data from consecutive patients.
  • Audit of 10-years' experience with Laparoscopic ventral rectopexy (LVR) from January 1999 to December 2008.

Main Results:

  • 405 patients underwent LVR for internal rectal prolapse, total rectal prolapse, or rectocele/enterocele.
  • Low conversion rate (2%) and no postoperative mortality; recurrence observed in 4.6%.
  • Symptomatic improvement in 85% with total rectal prolapse and 70% with internal rectal prolapse.

Conclusions:

  • Laparoscopic ventral rectopexy (LVR) is safe and feasible with low morbidity.
  • Functional outcomes support the efficacy of LVR for rectal prolapse.
  • Optimizing the indication for LVR in internal rectal prolapse patients is recommended.