Laparoscopic ventral mesh rectopexy in a male patient
Epublication WebSurg.com, May 2015;15(05). URL: http://websurg.com/doi/vd01en4511
Introduction Ventral rectopexy, with or without mesh, has a lower recurrence rate than a perineal approach for rectal prolapse treatment. One of the techniques which are gaining a wider acceptance is the laparoscopic ventral mesh rectopexy, also called D'Hoore rectopexy. The unique feature of this technique is that it avoids any posterolateral dissection of the rectum. Clinical outcomes demonstrate that this technique present good results in terms of recurrence, a low rate of constipation induced by the procedure, as well a low risk of sexual dysfunction. Clinical case A 43-year-old man was admitted to our hospital with a one-year evolution of rectal prolapse with complaints of sporadic rectal bleeding and soiling. He reports daily bowel movements with a necessity of manual prolapse reduction. His past medical history includes follicular lymphoma. He has no history of previous surgeries. After preoperative investigation with colonoscopy, a barium enema and anorectal function tests, a laparoscopic D’Hoore rectopexy was proposed to the patient. In this video, we present the critical steps of the procedure with special attention to the preservation of the hypogastric nerves. The postoperative outcome was uneventful. In the follow-up period, the patient reports a significant improvement of symptoms, without rectal prolapse at defecation, no constipation, and no change in sexual function.