Annals of Coloproctology

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Laparoscopic Posterolateral Rectopexy for the Treatment of Patients With a Full Thickness Rectal Prolapse: Experience With 63 Patients and Short-term Outcomes: Keehoon Hyun, Shi-Jun Yang, Ki-Yun Lim, Jong-Kyun Lee, Seo-Gue Yoon; Ann Coloproctol. 2018;34(3):119-124. Published online June 30, 2018; DOI: https://doi.org/10.3393/ac.2018.01.31

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Purpose
Although numerous procedures have been proposed for the treatment of patients with a rectal prolapse, the most effective operation has not yet been established. Minimal rectal mobilization can prevent constipation; however, it is associated with increased recurrence rates. We describe our novel method for a laparoscopic posterolateral rectopexy, which includes rectal mobilization with a posterior-right unilateral dissection, suture fixation to the sacral promontory with a polypropylene mesh (Optilene), and a mesorectal fascia propria that is as wide as possible. The present report describes our novel method and assesses the short-term outcomes of patients.
Methods
Between June 2014 and June 2017, 63 patients (28 males and 35 females) with a full-thickness rectal prolapse underwent a laparoscopic posterolateral (LPL) rectopexy. We retrospectively analyzed the clinical characteristics and postoperative complications in those patients. The outcome of surgery was determined by evaluating the answers on fecal incontinence questionnaires, the results of anal manometry preoperatively and 3 months postoperatively, the patients’ satisfaction scores (0–10), and the occurrence of constipation.
Results
No recurrence was reported during follow-up (3.26 months), and 3 patients reported postoperative complications (wound infection, postoperative sepsis, which was successfully treated with conservative management, and retrograde ejaculation). Compared to the preoperative baseline, fecal incontinence at three months postoperatively showed an overall improvement. The mean patient satisfaction score was 9.55 ± 0.10, and 8 patients complained of persistent constipation.
Conclusion
LPL rectopexy is a safe, effective method showing good functional outcomes by providing firm, solid fixation for patients with a full-thickness rectal prolapse.

Citations

Citations to this article as recorded by

Anatomical and functional outcomes of rectal prolapse treatment with laparoscopic pelvic organ prolapse suspension versus laparoscopic ventral mesh rectopexy
Adel Zeinalpour, Alimohammad Bananzadeh, Mohammad Mostafa Safarpour, Sara Shojaei‐Zarghani, Seyede Saeideh Shahidinia, Seyed Vahid Hosseini, Ali Reza Safarpour
Surgical Practice.2025; 29(1): 26. CrossRef
Surgical outcomes on health-related quality of life in rectal prolapse: A systematic review and meta-analysis
Hannaneh Yousefi-Koma, Yassin Rahnama, Dorsa Najari, Fatemeh Fathabadi, Mojtaba Sedaghat, Alireza Kazemeini, Mohammad Reza Keramati, Amir Keshvari, Mohammad Sadegh Fazeli, Behnam Behboudi, Seyed Mohsen Ahmadi-Tafti
Techniques in Coloproctology.2025;[Epub] CrossRef
Clinical outcomes of surgical management for recurrent rectal prolapse: a multicenter retrospective study
Kwang Dae Hong, Keehoon Hyun, Jun Won Um, Seo-Gue Yoon, Do Yeon Hwang, Jaewon Shin, Dooseok Lee, Se-Jin Baek, Sanghee Kang, Byung Wook Min, Kyu Joo Park, Seung-Bum Ryoo, Heung-Kwon Oh, Min Hyun Kim, Choon Sik Chung, Yong Geul Joh
Annals of Surgical Treatment and Research.2022; 102(4): 234. CrossRef
Laparoscopic Posterolateral Suture Rectopexy for Recurrent Rectal Prolapse in Children
Sherif M. Shehata, Ahmed A. Elhaddad, Wael M. Abo Senna, Mohamed A. Shehat
Journal of Laparoendoscopic & Advanced Surgical Techniques.2019; 29(10): 1292. CrossRef
Changing Trend of Rectal Prolapse Surgery in the Era of the Minimally Invasive Surgery
Suk-Hwan Lee
The Journal of Minimally Invasive Surgery.2019; 22(4): 135. CrossRef

Laparoscopic Vaginal Suspension and Rectopexy for Rectal Prolapse: Shi-Jun Yang, Seo-Gue Yoon, Ki-Yun Lim, Jong-Kyun Lee; Ann Coloproctol. 2017;33(2):64-69. Published online April 28, 2017; DOI: https://doi.org/10.3393/ac.2017.33.2.64

9,305 View
111 Download
15 Web of Science
16 Citations

Abstract PDF

Purpose

Laparoscopic procedures for the treatment of patients with a rectal prolapse have gained increasing worldwide acceptance because they have lower recurrence and better functional outcome than perineal procedures. Nevertheless, ideal surgical methods are still not available. We propose a new surgical technique, laparoscopic vaginal suspension and rectopexy, for correcting a full-thickness rectal prolapse and/or middle-compartment prolapse. This study assessed the short-term outcomes for patients who underwent laparoscopic vaginal suspension and rectopexy.

Methods

Between April 2014 and April 2016, 69 female patients underwent laparoscopic vaginal suspension and rectopexy to correct a rectal prolapse. Demographics, medical histories, and surgical and follow-up details were collected from their medical records. In addition to the clinical outcome, we repeated defecation proctography and a questionnaire regarding functional results three months after surgery.

Results

No major morbidities or no mortalities occurred. The defecation proctography confirmed excellent anatomical result in all cases. Of 7 patients with combined middle-compartment prolapses, we observed good anatomical correction. During follow-up, full-thickness recurrence occurred in one patient. Preoperative fecal incontinence was improved significantly at 3 months (mean Wexner score: 12.35 vs. 7.71; mean FISI: 33.29 vs. 21.07; P < 0.001). Analysis of responses to the fecal incontinence quality of life (FIQOL) questionnaire showed overall improvement at 3 months compared to the preoperative baseline (mean pre- and postoperative FIQOL scores: 12.11 vs. 14.39; P < 0.004).

Conclusion

Laparoscopic vaginal suspension and rectopexy is a new combined procedure for the treatment of patients with rectal prolapses. It has excellent functional outcomes and minimal morbidity and can correct and prevent middlecompartment prolapses.

Citations

Citations to this article as recorded by

Surgical outcomes on health-related quality of life in rectal prolapse: A systematic review and meta-analysis
Hannaneh Yousefi-Koma, Yassin Rahnama, Dorsa Najari, Fatemeh Fathabadi, Mojtaba Sedaghat, Alireza Kazemeini, Mohammad Reza Keramati, Amir Keshvari, Mohammad Sadegh Fazeli, Behnam Behboudi, Seyed Mohsen Ahmadi-Tafti
Techniques in Coloproctology.2025;[Epub] CrossRef
Surgical and Functional Outcome of Laparoscopic Vaginal Suspension Combined with Suture Rectopexy for Management of Pelvic Organ Prolapse
Mohamed I. Abuelnasr, Ahmed M. F. Salama, Ahmed M. Nawar
Journal of Coloproctology.2024; 44(01): e1. CrossRef
Mesh-associated complications in minimally invasive ventral mesh rectopexy: a systematic review
Gabriel Fridolin Hess, Fabio Nocera, Stephanie Taha-Mehlitz, Sebastian Christen, Marco von Strauss Und Torney, Daniel C. Steinemann
Surgical Endoscopy.2024; 38(12): 7073. CrossRef
Modified robotic ventral rectopexy with folded single titanized mesh suspension for the treatment of complex pelvic organ prolapse
Bernardina Fabiani, Alessandro Sturiale, Lisa Fralleone, Claudia Menconi, Vittorio d'Adamo, Gabriele Naldini
Colorectal Disease.2023; 25(3): 453. CrossRef
Natural Orifice Transanal Endoscopic Rectopexy for Complete Rectal Prolapse: Prospective Evolution of a New Technique and Short-term Outcomes
Abhijit Chandra, Pritheesh Rajan, Vivek Gupta, Saket Kumar, Mahesh Rajashekhara, Ravi Patel, Bharat Sangal, Vikram Singh
Diseases of the Colon & Rectum.2023; 66(1): 118. CrossRef
Assessment of feasibility of abdominal mesh vaginorectopexy in the repair of multiple pelvic organ prolapse
Mohamed Mazloum Zakareya, Walid Galal Elshazly, Ahmed Mohamed Moaz, Bassem Khamis Hegazy
Alexandria Journal of Medicine.2023; 59(1): 15. CrossRef
A quantitative study to explore functional outcomes following laparoscopic ventral mesh rectopexy for rectal prolapse
O Olatunbode, S Rangarajan, V Russell, YKS Viswanath, A Reddy
The Annals of The Royal College of Surgeons of England.2022; 104(6): 449. CrossRef
Postoperative complications and pelvic organ prolapse recurrence following combined pelvic organ prolapse and rectal prolapse surgery compared with pelvic organ prolapse only surgery
Shannon L. Wallace, Youngwu Kim, Erica Lai, Shailja Mehta, Bertille Gaigbe-Togbe, Chiyuan Amy Zhang, Emily C. Von Bargen, Eric R. Sokol
American Journal of Obstetrics and Gynecology.2022; 227(2): 317.e1. CrossRef
A Collaborative Approach to Multicompartment Pelvic Organ Prolapse
Brooke Gurland, Kavita Mishra
Clinics in Colon and Rectal Surgery.2021; 34(01): 069. CrossRef
Postoperative complications and recurrence rates after rectal prolapse surgery versus combined rectal prolapse and pelvic organ prolapse surgery
Shannon L. Wallace, Ekene A. Enemchukwu, Kavita Mishra, Leila Neshatian, Bertha Chen, Lisa Rogo-Gupta, Eric R. Sokol, Brooke H. Gurland
International Urogynecology Journal.2021; 32(9): 2401. CrossRef
European Society of Coloproctology guidance on the use of mesh in the pelvis in colorectal surgery
Yasuko Maeda, Eloy Espin‐Basany, Kim Gorissen, Mia Kim, Paul‐Antoine Lehur, Lilli Lundby, Ionut Negoi, Gregor Norcic, P. Ronan O’Connell, Tero Rautio, Bart van Geluwe, Gabrielle H. van Ramshorst, Andrea Warwick, Carolynne J. Vaizey
Colorectal Disease.2021; 23(9): 2228. CrossRef
Transvaginal rectopexy using the Flex® Colorectal Drive Robotic System: a proof-of-concept approach to rectal prolapse
J. O. Paull, A. Graham, S. Parascandola, S. Hota, S. Stein, B. Umapathi, A. Abdullah, N. Pudalov, V. Obias
Techniques in Coloproctology.2020; 24(5): 471. CrossRef
Clinical efficacy of integral theory–guided laparoscopic integral pelvic floor/ligament repair in the treatment of internal rectal prolapse in females
Yang Yang, Yong-Li Cao, Yuan-Yao Zhang, Shou-Sen Shi, Wei-Wei Yang, Nan Zhao, Bing-Bing Lyu, Wen-Li Zhang, Dong Wei
World Journal of Clinical Cases.2020; 8(23): 5873. CrossRef
Clinical efficacy of integral theory–guided laparoscopic integral pelvic floor/ligament repair in the treatment of internal rectal prolapse in females
Yang Yang, Yong-Li Cao, Yuan-Yao Zhang, Shou-Sen Shi, Wei-Wei Yang, Nan Zhao, Bing-Bing Lyu, Wen-Li Zhang, Dong Wei
World Journal of Clinical Cases.2020; 8(23): 5876. CrossRef
Clinical Outcome and Surgical Technique of Laparoscopic Posterior Rectopexy Using the Mesh With Anti-adhesion Coating
Yasunori Matsuda, Masahiro Nishikawa, Satoshi Nishizawa, Yoshinori Yane, Hokuto Ushijima, Taigo Tokuhara
Surgical Laparoscopy, Endoscopy & Percutaneous Techniques.2019; 29(4): e41. CrossRef
Comparison of Delorme-Thiersch Operation Outcomes in Men and Women With Rectal Prolapse
Keehoon Hyun, Seo-Gue Yoon
Annals of Coloproctology.2019; 35(5): 262. CrossRef

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