Laparoscopic Ventral Mesh Rectopexy in the management of Complete Rectal Prolapse. Experience from a lower middle income Country
Author(s): Muhammad Adeel Kaiser, Muhammad Qasim Farooq, Awais Amjad Malik*, Anwar Zeb Khan, Hasrat Khan Wifaq, Muhammad Imran Khokhar, Muhammad Farooq Afzal
Objective: To analyze short term outcomes of laparoscopic ventral mesh rectopexy in the management of complete rectal prolapse (CRP).
Method and Material: From July 2017 to Dec 2019 all patients admitted with a diagnosis of rectal prolapse were included in the study. Patients underwent D hoore technique of laparoscopic ventral mesh rectopexy. Prolene mesh was used in all cases. Patients were followed for improvement in bowel function, post operative complications and early recurrences.
Results: 12 patients were admitted with a diagnosis of rectal prolapse. Two underwent perineal resections and were not included in the study. 10 patients were included in the study. Median age was 38.6 years (16- 50). Male: Female ratio was 1:1. Median operative time was 130min (90-150) Median postoperative stay was 3 days (2-5). All 10 patients had full thickness rectal prolapse and 2 patients had associated vaginal vault prolapse. 8 patients had associated constipation; 1 had incontinence and 1 had per rectal bleed. All patients were discharged on laxatives for three weeks. Patients were followed for a median 18 months (12-26 months). There were no recurrences. There were 2 port site infection. No patients develop sexual dysfunction, incontinence or dyspareunia.
Conclusion: LMVR can be performed safely by experienced surgeons and Nerve sparing technique result in less complications and better results in terms of recurrence and improvement of bowel dysfunction.