Stapled laparoscopic rectopexy for rectal prolapse

Abstract

The widespread success of laparoscopic cholecystectomy has led to the development of a wide range of laparoscopic surgical procedures. Procedures for treating rectal prolapse (Procidentia) may constitute some of the best applications for colorectal laparoscopic techniques. A technique of laparoscopic rectopexy performed using the endo-stapler is described. Twenty-nine consecutive patients have undergone laparoscopic rectopexy. The median age was 71 years (52-89), and male:female ratio was 27:2. One procedure had to be converted to open due to ventilatory difficulties. The mean operative time was 95 minutes (50-190). The mean hospital stay was 5 days (4-15). There was no mortality in this series. Morbidity included incisional hernia through a port hole (n = 1), extraperitoneal haematoma (n = 1), and urinary tract infection with retention (n = 1). In conclusion, laparoscopic abdominal rectopexy is a safe and effective technique in the management of rectal prolapse.

Laparoscopic treatment of rectal prolapse: experience gained in a prospective multicenter study

“…The resulting restriction in social activities, together with increasing social isolation caused by the patient's uncertainty outside the home, was the main reason for their undergoing surgery. The surgical strategy and technique is largely analogous to those in conventional transabdominal procedures [4,9,11,21,22,24]. Were employed either resection alone, rectopexy alone, or a combination of the two,.…”

“…The most commonly observed problems were general complications such as urinary tract infection (11,7.3%), motility disorders of the bowel lasting for more than 3 days (6, 4.0%), and cardiopulmonary problems (5, 3.3%). The leading surgical postoperative complications were ileus requiring reoperation (4, 2.7%) and wound healing disorders (4, 2.7%), followed by anastomotic insufficiency (3, 2.0%) and afterbleeding requiring reoperation (2, 1.3%).…”

Laparoscopic Surgery of the Colon and Rectum

“…A variety of techniques have been described to treat this condition, using a simple suture method (suture rectopexy) [34] or inserting a prosthetic mesh (usually polypropylene) [35] to fix the rectum in place after it is thoroughly mobilized from surrounding pelvic attachments. We have performed rectopexy using a suture technique in 23 patients thus far, with only one recurrence after a median follow-up of 29 months (unpublished data).…”

Laparoscopic surgery and rectal prolapse: Personal experience

“…On the basis of this experience, we began to perform the same procedure through laparoscopy [8]; as reported by other authors [6], our preliminary results ate encouraging and allow us to state that the laparoscopic approach is safe and effective, and could represent the treatment of choice for rectal prolapse.…”