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Laparoscopic Posterolateral Suture Rectopexy for Recurrent Rectal Prolapse in Children
Sherif M Shehata1, Ahmed A Elhaddad1, Wael M Abo Senna1
1Section of Pediatric Surgery, Surgery Department, Faculty of Medicine, Tanta University, Tanta, Egypt.
Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
|September 24, 2019
Summary
Posterolateral laparoscopic suture rectopexy (LSR) is an effective treatment for recurrent rectal prolapse (RP) in children. This technique successfully addressed the hernia-like physiology associated with recurrent RP, with minimal recurrence rates observed.
Area of Science:
- Pediatric surgery
- Gastrointestinal surgery
- Minimally invasive procedures
Background:
- Recurrent rectal prolapse (RP) in children presents a surgical challenge.
- Laparoscopic rectopexy is increasingly utilized for RP management.
- Understanding the hernia-like physiology in recurrent RP is crucial for successful treatment.
Purpose of the Study:
- To evaluate the efficacy of posterolateral laparoscopic suture rectopexy (LSR) in children with recurrent rectal prolapse.
- To present surgical experience and outcomes of LSR for pediatric recurrent RP.
Main Methods:
- A retrospective study of 16 pediatric patients with recurrent RP undergoing LSR.
- Procedure involved dissection of the peritoneal sac, closure of the deep pouch, and fixation of the rectum/sigmoid.
- Fixation to the sacral promontory was performed when rectal redundancy was evident.
Main Results:
- The study included 11 girls and 5 boys aged 3-12 years.
- Ten patients had prior injection therapy, and 6 had failed Thiersch procedures.
- One case of postoperative mucosal prolapse occurred; no full-thickness recurrences were noted during a mean 19.5-month follow-up.
Conclusions:
- Posterolateral laparoscopic suture rectopexy (LSR) is an efficient surgical option for carefully selected pediatric patients with recurrent rectal prolapse.
- LSR appears to effectively address the underlying pathology of recurrent RP.
- Further research with longer follow-up is needed to standardize the LSR technique.
