[Abdominal rectopexy (Orr-Loygue) in rectal prolapse: celioscopic approach or conventional surgery]

One of the treatment modalities for rectal prolapse is abdominal rectopexy, a comparison of the Orr-Loygue procedure, performed by laparotomy and by laparoscopy was done. From June 1981 and May 1993, 31 females and 3 males, with an average of age of 58.8 were operated. Twelve patients were operated by laparoscopy (group I) and 22 patients by laparotomy (group II). Two patients (16.7%) in group I were converted to a laparotomy due in one to operative hemorrhage and in the other to adhesions. Seven patients in group I and 18 in group II had had previous abdominal surgery. Average operative time was 2.56 hours and 2.25 hours for groups I and II respectively. A reduction in post operative hospital stay (5 vs 8.3 days) as well as in intramuscular analgesic requirements (5.5 vs. 14.1 doses) was observed in group I vs. group II respectively. Time to oral intake and cessation of intravenous fluids were also reduced in group I compared to group II (1.0 vs. 3.9 days and 2 vs. 5.8 days respectively). No mortality and minimal morbidity was observed in both groups. No recurrence of prolapse was noted in either group with an average of 12.6 mouths follow-up (2.8 to 17 months). We concluded that rectopexy by laparoscopy is technically feasible and has undeniable advantages over laparotomy.