Rectal prolapse

Marlex rectopexy is a popular and effective procedure for the repair of rectal prolapse. Heretofore, this operation has required a generous laparotomy. As videolaparoscopy provides superior pelvic exposure, performing a modified Ripstein procedure was a logical progression of minimally invasive surgery. Experience with the first sutured Marlex rectopexy suggested the need for a simple fixation device to secure the mesh to the sacrum. A commercially available orthopedic staple allows quick and secure fixation. Five cases of laparoscopic Marlex rectopexy provide our initial clinical experience. The LCR staple has reduced operating times by up to 1 h. Results in these cases show virtual complete repair of the prolapse, minimal postoperative analgesic requirements, and no postoperative incontinence. There was one postoperative complication requiring reoperation. There were no deaths. Laparoscopic stapled Marlex rectopexy is a promising modality for the treatment of procidentia.