Laparoscopic ventral mesh rectopexy for pelvic floor dysfunction is a safe procedure: a single centre experience (2022)

Type of publication:
Conference abstract

*Chang J.; *Rajalingam V.; *Ebanks A.; *Lacy-Colson J.; *Farquharson A.

Colorectal Disease. Conference: Association of Coloproctology of Great Britain and Ireland Annual Meeting. Edinburgh United Kingdom. 24(Supplement 2) (pp 65), 2022. Date of Publication: September 2022.

Purpose: Laparoscopic Ventral Mesh Rectopexy (LVMR) is an established treatment option in the management of internal and external rectal prolapse. However, there is some concern regarding the safety and long-term outcomes of the use of mesh in the pelvis. The Pelvic Floor Society (TPFS) has suggested a move towards delivering this surgery in accredited units in the UK. We present our experience and outcomes for LVMR where a standardised technique is performed. Method(s): All patients who underwent LVMR between 2012 and 2020 at a single centre were included. Clinical indications for surgery, preoperative proctogram, endoanal ultrasound, anorectal physiology, pre and postoperative symptom severity scoring (Longo and Wexner) and outcome data were collected and analysed. Result(s): 146 patients underwent LVMR during the study period. Indications included; faecal incontinence (FI) (5), obstructive defecation syndrome (ODS) (74), mixed ODS/FI (34), and external rectal prolapse (32). One patient required re-operation for vaginal erosion of mesh suture (4 years post-LVMR). No other mesh complications were identified. 100 patients had resolution of symptoms, 46 had symptomatic improvement but required ongoing therapies (rectal irrigation, laxatives or biofeedback therapy). Ten patients underwent subsequent sutured transanal mucosal repair or haemorrhoidectomy for ongoing symptoms of ODS. Two patients developed recurrence of external prolapse which required operation: Delorme's (1), repeat LVMR (1). Conclusion(s): LVMR is a safe and effective procedure for pelvic floor dysfunction and the treatment of internal and external rectal prolapse in selected patients. Undertaking a standardised procedure in high volume units ensures optimal patient outcomes.

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