Laparoscopic ventral rectopexy using the transanal vacuum test for complete rectal prolapse.

Area of Science:

• Gastroenterology
• Colorectal Surgery
• Surgical Innovation

Background:

• Complete rectal prolapse is a debilitating condition requiring surgical intervention.
• Laparoscopic ventral rectopexy is a common surgical approach.
• Recurrence remains a challenge after laparoscopic ventral rectopexy, particularly in long-standing cases.

Purpose of the Study:

• To evaluate the efficacy of the transanal vacuum test in reducing recurrence after laparoscopic ventral rectopexy.
• To assess the impact of the transanal vacuum test on surgical decision-making during rectopexy.
• To compare recurrence rates before and after the implementation of the transanal vacuum test.

Main Methods:

• A retrospective analysis of 84 patients undergoing laparoscopic ventral rectopexy between January 2016 and December 2019.
• Implementation of the transanal vacuum test to assess rectal prolapse intraoperatively.
• Conversion to laparoscopic posterior rectopexy if the transanal vacuum test indicated persistent prolapse.

Main Results:

• The initial recurrence rate after laparoscopic ventral rectopexy was 11.1% (3/27) in cases without the transanal vacuum test.
• After implementing the transanal vacuum test, the recurrence rate decreased significantly to 1.7% (1/57).
• The transanal vacuum test guided conversion to laparoscopic posterior rectopexy in 37 out of 94 attempted laparoscopic ventral rectopexies.

Conclusions:

• The transanal vacuum test is a valuable tool for intraoperative assessment of rectal prolapse.
• Utilizing the transanal vacuum test during laparoscopic ventral rectopexy can significantly reduce postoperative recurrence rates.
• This technique enhances surgical precision and improves outcomes for patients with complete rectal prolapse.