Laparoscopic Mesh Sacropexy for Voluminous Rectocele.

Area of Science:

• Gastroenterology
• Gynecology
• Surgical Innovation

Background:

• Rectocele, a rectal protrusion through rectovaginal fascia, presents as a posterior vaginal bulge.
• Voluminous rectoceles are rare and pose significant surgical challenges.
• Traditional surgical approaches include transvaginal, transanal, transperineal, and transabdominal methods.

Purpose of the Study:

• To present a novel surgical technique for managing voluminous rectocele.
• To evaluate the efficacy of laparoscopic mesh sacropexy in treating severe rectocele cases.

Main Methods:

• Laparoscopic mesh sacropexy involves retrorectal and rectovaginal dissection to the pelvic floor.
• A Y-shaped polypropylene mesh is used for rectovaginopexy to the sacral promontory.
• The mesh anchors the rectum and posterior vaginal wall, replacing the damaged rectovaginal fascia.

Main Results:

• The procedure significantly improved the main symptom of difficulty in defecation.
• Patients no longer required digital maneuvers for rectal evacuation post-surgery.
• The polypropylene mesh effectively substituted the damaged rectovaginal fascia, anchoring the prolapsed structures.

Conclusions:

• Laparoscopic mesh sacropexy is a feasible and effective solution for voluminous rectocele.
• This technique offers a promising approach for challenging rectocele cases.
• The procedure demonstrates good outcomes in improving patient symptoms and quality of life.