Assessment of Laparoscopic Posterior Mesh Rectopexy for Complete Rectal Prolapse: A Case Series with Review of Literature

Abstract

Background Trans-abdominal rectopexy for complete rectal prolapse (CRP) reportedly yields more definitive results as compared with trans-perineal surgery. In the era of minimal access surgery, minimally invasive laparoscopic rectopexy has become a popular treatment option for patients with rectal prolapse (RP). Herein, we describe our preferred surgical procedure for the correction of RP and evaluate its results. We further aim to perform a comparative assessment between perioperative outcomes achieved with open and laparoscopic applications of this technique. Materials and methods This was a retrospective cross-sectional observational study conducted at a tertiary health care center in Maharashtra, India. We studied cases of RP who underwent laparoscopic posterior mesh rectopexy during the past 15 years (2005–2021), in our institution, operated upon by a single surgeon. Results Of the total 14 patients, 12 were managed with laparoscopic posterior mesh rectopexy. The remaining two underwent laparoscopic suture rectopexy. The mean operative time was 120 minutes. Constipation improved among 28.57%, remained the same among 21.42%, and worsened among 35.71% patients. No intra-operative blood transfusion was required. Mean length of hospital stay was 4 days. There were no recurrences over a mean follow-up period of 94 months, i.e., 7.83 years (range 7–197 months). Conclusions Laparoscopic posterior rectopexy can be safely performed in older patients to achieve early postoperative ambulation and significantly shorten the hospital stay. It may, therefore, be considered an effective treatment for CRP and urinary dysfunction. However, the incidence of de-novo constipation and worsening of pre-existing constipation is significantly high.

Posterior Mesh Rectopexy versus Resection Rectopexy in Complete Rectal Prolapse.

“…In Chawda & Joshi study, which assessed the demographic features of all the 14 study subjects who presented with RP; they observed that the mean age of the subjects was 48.42 years .There was a male preponderance observed in this study, which is against a well established female preponderance in the disease. The observed M:F ratio was 1.8:1 (14) . As regard operative time; it was shorter in mesh rectopexy group than in resection rectopexy .…”