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Laparoscopic Rectopexy with Urinary Bladder Xenograft Reinforcement.
Aradhana Mehta1, Rami Afshar1, David L Warner1
1University of Nevada School of Medicine, Reno, Nevada, USA.
JSLS : Journal of the Society of Laparoendoscopic Surgeons
|April 13, 2017
Summary
Laparoscopic rectopexy using urinary bladder matrix (UBM) xenografts for rectal prolapse repair showed no recurrences or major complications at 3-year follow-up. This biologically derived material offers a safe and durable alternative to synthetic mesh, reducing recurrence rates.
Area of Science:
- Colorectal surgery
- Surgical innovation
- Biomaterials in medicine
Background:
- Rectal prolapse repair often involves laparoscopic techniques with reinforcement materials.
- Synthetic meshes reduce recurrence but pose risks like erosion and infection.
- Urinary bladder matrix (UBM) is a biological alternative for durable repair without synthetic risks.
Purpose of the Study:
- To evaluate the effectiveness and durability of laparoscopic rectopexy using UBM xenograft reinforcement.
- To assess functional outcomes at three years post-procedure.
Main Methods:
- Laparoscopic rectopexy with presacral UBM reinforcement was performed on 20 patients.
- Follow-up averaged 3 years, including interviews, physical exams, manometry, and FISI scores.
Main Results:
- No full-thickness recurrences, erosions, or reoperations occurred in 3 years.
- One postoperative abscess was managed; no other complications arose.
- Low fecal incontinence severity (average FISI 8) and minimal mucosal prolapse observed.
Conclusions:
- Laparoscopic rectopexy with UBM reinforcement is safe and effective for rectal prolapse.
- UBM grafts provide durable repair at 3-year follow-up, serving as a viable alternative to synthetic mesh.
- Further research on UBM's advantages and cost-effectiveness is warranted.