Laparoscopic approach to recurrence following multiple surgeries for external rectal prolapse: a case report

Area of Science:

• Colorectal Surgery
• Minimally Invasive Surgery
• Pelvic Reconstructive Surgery

Background:

• Optimal surgical management for recurrent external rectal prolapse, especially via laparoscopy, is not well-defined.
• Pelvic organ prolapse (POP) can coexist with rectal prolapse, complicating treatment.
• Previous surgical history included perineal rectosigmoidectomy and laparoscopic posterior mesh rectopexy.

Purpose of the Study:

• To present a case of recurrent full-thickness external rectal prolapse with concomitant pelvic organ prolapse.
• To describe the successful laparoscopic surgical approach for this complex condition.

Main Methods:

• Laparoscopic ventral mesh rectopexy (LVMR) combined with laparoscopic sacrocolpopexy (LSC).
• Utilized self-cut meshes for the procedure.
• Managed a recurrent rectal prolapse coexisting with cystocele and vaginal prolapse.

Main Results:

• The combined LVMR and LSC procedure was performed without perioperative complications.
• Successfully addressed both recurrent rectal prolapse and concomitant pelvic organ prolapse.
• Demonstrated feasibility in an 81-year-old female patient.

Conclusions:

• This is the first reported case of LVMR and LSC for recurrent rectal prolapse with POP after prior rectopexy procedures.
• The combined laparoscopic approach appears to be a safe and effective option for recurrent rectal prolapse with concomitant POP.
• Suggests LVMR and LSC as a potential treatment strategy for complex recurrent rectal prolapse cases.