Nerve preserving vs standard laparoscopic sacropexy: Postoperative bowel function.

Area of Science:

• Gastroenterology
• Colorectal Surgery
• Pelvic Floor Disorders

Background:

• Apical prolapse can lead to significant bowel symptoms.
• Standard laparoscopic sacropexy may cause de novo bowel dysfunction.
• Nerve preservation is crucial for maintaining bowel function.

Purpose of the Study:

• To compare a novel nerve-preserving laparoscopic sacropexy (LSP) technique with the standard LSP.
• To evaluate the incidence of de novo bowel symptoms after each procedure.

Main Methods:

• Prospective comparison of 43 women with symptomatic apical prolapse.
• Group A: Nerve-preserving LSP (n=25). Group B: Standard LSP (n=18).
• Functional and anatomical data collected via questionnaires and anorectal manometry.

Main Results:

• No de novo bowel dysfunction occurred in the nerve-preserving group (Group A) versus 4 cases in the standard group (Group B) (P=0.02).
• Obstructed defecation syndrome was assessed using questionnaires and manometry.
• Comparable apical recurrence and late complications; no major intraoperative complications with the new technique.

Conclusions:

• The developed nerve-preserving technique is superior to the standard method in preventing de novo bowel dysfunction.
• The nerve-preserving approach is safe, with no increase in operative time or major complications.