Medium term results for laparoscopic ventral rectopexy using permacol for pelvic organprolapse: LTP04


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Abstract

Aim:The technique of laparoscopic ventral rectopexy using biologic mesh to manage pelvic floor disorders is relatively new.Method:Data from all consecutive patients undergoing laparoscopic ventral rectopexy wereprospectively entered in a database. Outcome parameters were Wexner constipation and incontinence scores, early and late complications and recurrence. Results were compared using Wilcoxon signed rank tests (two-tailed p-test).Results:Fifty-eight patients (median age 62, range 31-89) underwent laparoscopic ventral rectopexy with a PermacolTM (Covidien, North Haven, CT, USA) mesh between May 2008 and May 2010 (median follow-up 6 months, range 1-24). Theprimary indications for surgery were full-thickness rectalprolapse (n = 24), rectocele with obstructive defaecation symptoms (n = 21), vaginal vaultprolapse (n = 12) and faecal incontinence (n = 1). Improvements in Wexner constipation and faecal incontinence scores were significant at 6 months (n = 38) and 1 year (n = 23) (P < 0.05). At 6 months and 1 year symptoms were rated as much better or better by 92% and 95% of patients respectively. Nobody stated a worsening of symptoms. There was one conversion to an openprocedure. Early complications occurred in five patients (9%) and late complications in two patients (3%). There was no mortality. Recurrence of symptoms occurred in two patients (3%).Conclusion:Laparoscopic ventral rectopexy using biologic mesh is a safe and effective treatment for pelvic organprolapse, including the underlying functional disorder.

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