Laparoscopic surgery for rectal prolapse and pelvic floor disorders

Area of Science:

• Gastroenterology and Gynecology
• Surgical Innovation
• Pelvic Floor Medicine

Background:

• Pelvic floor disorders (PFDs) involve dysfunctions of gynecological, urinary, or anorectal organs, manifesting as incontinence, outlet obstruction, or organ prolapse.
• These conditions significantly impact a substantial portion of the population, predominantly women.
• Transabdominal surgical procedures are crucial for managing PFDs, with a shift towards laparoscopic techniques.

Purpose of the Study:

• To evaluate and compare different transabdominal surgical techniques for pelvic floor disorders.
• To assess operative and functional outcomes, as well as recurrence rates of various rectopexy methods.
• To address the lack of standardized outcome measures and high-quality comparative studies in the field.

Main Methods:

• Review of established open and increasingly laparoscopic surgical procedures for PFDs.
• Analysis of rectopexy techniques, including suture, staple, or mesh fixation, with or without sigmoid resection.
• Examination of observational and retrospective studies on current laparoscopic approaches.

Main Results:

• Laparoscopic ventral mesh rectopexy and resection rectopexy are currently the most common techniques.
• Observational and retrospective studies indicate favorable functional outcomes.
• These commonly used laparoscopic methods demonstrate a low complication rate and low recurrence rates.

Conclusions:

• High-quality evidence comparing surgical methods for PFDs is limited due to non-standardized outcome measures and a lack of randomized trials.
• Current evidence suggests good functional results and low recurrence rates for laparoscopic ventral mesh rectopexy and resection rectopexy.
• An individualized treatment approach is recommended, considering patient age, health status, and specific disorder characteristics.