The use of prosthetic material in rectopexies

Among the 80 different techniques that have been devised to repair rectal prolapse, abdominal rectopexies are the most suitable. The majority of these operations secure the rectum to the sacrum by means of a prosthetic material. Ripstein's technique, in USA, and Wells procedure, in Great Britain, have gained wide acceptance, despite a rather high rate of complications. A modified technique has been recently proposed by Keighley et al., with excellent results. From 1979 to 1982, 20 patients were operated upon in our department for rectal prolapse. The mean age of the patients was 43 years, and there was a rather high percentage of male patients (30%). Eleven exhibited an obvious external prolapse patients (30%). Eleven exhibited an obvious external prolapse but the others complained of the "occult rectal prolapse syndrome". The Orr-Loygue procedure, that secures the rectum to the sacral promontory by means of two strips of nylon mesh, was performed in all these cases. No mortality was observed and the morbidity was minimal. No infectious complications occurred. The procedure was performed without sexual consequences in the young patients. Clinical, endoscopic and cineradiographic checks illustrate that the Orr-Loygue rectopexy is an efficient treatment of both incipient intussusception and external prolapse, and offers good control of most associated troubles. But a longer survey is necessary before definitive conclusions may be drawn.