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Laparoscopic prosthesis fixation rectopexy for complete rectal prolapse

A Cuschieri1, S M Shimi, G Vander Velpen

  • 1Department of Surgery, Ninewells Hospital and Medical School, University of Dundee, UK.

The British Journal of Surgery
|January 1, 1994
PubMed
Summary
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Laparoscopic rectal mobilization and fixation using Marlex mesh effectively treated rectal prolapse and incontinence in elderly women. The procedure showed promising results with no prolapse recurrence during follow-up.

Area of Science:

  • Colorectal Surgery
  • Minimally Invasive Procedures
  • Pelvic Floor Disorders

Background:

  • Complete rectal prolapse and incontinence significantly impact quality of life in elderly women.
  • Surgical intervention is often necessary for severe cases unresponsive to conservative management.

Purpose of the Study:

  • To evaluate the efficacy and safety of laparoscopic rectal mobilization and posterior fixation using Marlex mesh for treating complete rectal prolapse and incontinence.
  • To assess the impact of surgical technique and instrumentation on operative time.

Main Methods:

  • Five women aged 64-81 years with complete rectal prolapse and incontinence underwent laparoscopic surgery.
  • The procedure involved rectal mobilization and fixation to the presacral fascia with Marlex mesh.

Related Experiment Videos

  • Two patients were operated on using standard straight instruments, while three utilized coaxial curved instruments and ultrasonic dissection.

    • Main Results:

    • Postoperative continence restoration was achieved in four out of five patients (two to grade 1, two to grade 2).
    • No recurrence of rectal prolapse was observed during a follow-up period ranging from 4 to 27 months.
    • Operative times were reduced with the use of coaxial curved instruments and ultrasonic dissection (2.0-2.5 hours) compared to standard instruments (3.5-4.5 hours).

    Conclusions:

    • Laparoscopic rectal mobilization and posterior fixation with Marlex mesh is a viable surgical option for complete rectal prolapse and incontinence in elderly women.
    • The use of advanced laparoscopic instruments may lead to shorter operating times.
    • The procedure demonstrates good long-term outcomes regarding prolapse recurrence and functional improvement.