Background: Total or complete rectal prolapse is the circumferential full-thickness protrusion of the rectal wall through the anus. Rectal prolapse is a major problem for both patients and surgeons. The aim of the treatment is to repair the prolapse and its complication (like incontinence) with minimal postoperative complication. Two approaches are generally possible to treat the patients; the perineal approach and abdominal approach, but both of them have many complications like obstructed defecation, fecal incontinence, and recurrence.
Since its invention, laparoscopic ventral rectopexy has many benefits for the patient, it is safe, effective, durable and minimally invasive. In this study, we evaluated the effect of Laparoscopic ventral rectopexy on fecal continence and postoperative morbidity (including constipation).
Aim of the study: Was to evaluate Laparoscopic ventral rectopexy for the treatment of rectal
prolapse.
Patients and methods: This was a prospective study carried out at Ain Shams University Hospitals in Egypt and Saudi German Hospital in Jeddah, in the period between May 2011 and January 2015. Laparoscopic ventral rectopexy was performed in 28 consecutive patients who required surgery for total rectal prolapse. Follow-up was done for early postoperative complication, hospital stay, recurrence, severity of fecal incontinence, which was assessed by Wexner's incontinence score and the presence of constipation (obstructed defecation and STC) and its treatment (including laxative and enema use) which was assessed by Adapted Rome II Criteria over the interval (3,6 and 12 months) postoperative.
Results: There were 28 patients who underwent laparoscopic ventral rectopexy (24 female and 4 male) with mean age 55.6 ± 5.3 years. The average operating time range was 153±26 min. There was no postoperative death and postoperative complications were minimal (one urinary tract infections & two pelvic collections). The mean postoperative stay was 5.8 days. Two patients had recurred disease, and twelve of the 21 incontinent patients became fully continent; seven others experienced only a minor degree of incontinence. Before surgery, 13 patients with symptoms of constipation 9 of them improved after surgery.
Conclusion: Laparoscopic ventral rectopexy is an effective, minimally invasive procedure
for the correction of rectal prolapse with minimal complications and lower recurrence rate.