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Laparoscopic ventral rectopexy for rectal prolapse and rectal intussusception using a biological mesh
S Albayati1, M J Morgan1, C E Turner1
1Department of Surgery, Bankstown Hospital, Sydney, New South Wales, Australia.
Summary
Laparoscopic ventral rectopexy (LVR) with biological mesh is safe for rectal prolapse. It significantly reduces faecal incontinence but may not fully resolve obstructed defecation symptoms.
Area of Science:
- Colorectal surgery
- Pelvic floor disorders
- Minimally invasive surgery
Background:
- Laparoscopic ventral rectopexy (LVR) is a nerve-sparing surgical approach for rectal prolapse.
- Concerns exist regarding synthetic mesh erosion in pelvic surgery.
- Biological meshes are emerging as an alternative to synthetic materials.
Purpose of the Study:
- To evaluate the outcomes of LVR using a noncross-linked, nondermal biological mesh.
- To assess the safety and efficacy of biological mesh in LVR.
- To analyze functional outcomes, including obstructed defecation and faecal incontinence.
Main Methods:
- Retrospective review of patient medical records for LVR procedures performed between December 2011 and May 2014.
- Determination of pre-operative obstructed defecation using Rome III criteria.
- Assessment of post-operative obstructed defecation and faecal incontinence via self-reported questionnaires.
Main Results:
- 51 patients underwent LVR with a mean follow-up of 23 months.
- Postoperative complications occurred in 13.7% of patients.
- Significant reduction in faecal incontinence (26.7% to 6.7%) and obstructed defecation (73.3% to 48.8%) was observed.
Conclusions:
- LVR utilizing biological mesh is a safe procedure for rectal prolapse.
- The technique leads to a significant decrease in symptoms of faecal incontinence.
- While beneficial, LVR with biological mesh may not completely resolve obstructed defecation symptoms in all patients.