Laparoscopic ventral mesh rectopexy has been one of the popular treatment options for full thickness rectal prolapse and obstructive defaecation. The procedure is known to have good initial results on bowel function. Given associated complications of mesh used in the pelvis more evidence regarding long-term outcomes has been needed in the literature. A recent large retrospective study by Mäkelä-Kaikkonen et al evaluates long-term functional results, sequelae, and outcome predictors for laparoscopic ventral mesh rectopexy. The follow up was questionnaire based, and the study had very good response rates.
Study results showed that long term symptom relief was achieved in 86% of patients who underwent the procedure for full thickness prolapse. When the procedure was used for intra-rectal intussusception long-term relief of symptoms was realised by 68% of patients. The recurrence rate for full thickness prolapse was 7.1% which is low compared to other prolapse repair operations. The complication rate was 11.4%.
This study shows that ventral mesh rectopexy has good results for long term repair of full thickness rectal prolapse. The results for intussusception were not as favourable, but acceptable. Importantly, the long-term complication rate was just over 10%. This information can help in decision making and patient counselling when considering options for full thickness prolapse surgery.
Mäkelä-Kaikkonen et al. Dis Colon Rectum. 2018 Feb;61(2):230-238.
Article by Alexis Schizas on behalf of the Publications and Communications Committee