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General and digestive surgery

Find all the surgical interventions, lectures, experts opinions, debates, webinars and operative techniques per specialty.
Laparoscopic ventral mesh rectopexy in a male patient
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.
M Manzanera Díaz, C Moreno Sanz, J De Pedro Conal, A Goulart, F Cortina Oliva
Surgical intervention
3 years ago
4443 views
247 likes
0 comments
07:35
Laparoscopic ventral mesh rectopexy in a male patient
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.
Laparoscopic anterior rectopexy for rectal prolapse
This video demonstrates the technique and steps required to perform a laparoscopic anterior rectopexy for the successful treatment of rectal prolapse. The treatment of rectal prolapse with a laparoscopic trans-abdominal approach is well-established and has resulted in reduced morbidity and shorter hospital stay. It is also well-tolerated in the elderly and shows an improvement in incontinence and a low recurrence rate. This procedure can be enhanced by using a purely anterior (ventral) approach. The dissection is kept anterior to the rectum, by opening the rectovaginal septum and then continuing down to the pelvic floor where a mesh rectopexy is then performed. This avoids posterior rectal dissection and spares the autonomic pelvic nerves; it keeps morbidity low and improves constipation.
J Saunders, P Thomas, K Badrinath
Surgical intervention
8 years ago
13418 views
229 likes
1 comment
06:56
Laparoscopic anterior rectopexy for rectal prolapse
This video demonstrates the technique and steps required to perform a laparoscopic anterior rectopexy for the successful treatment of rectal prolapse. The treatment of rectal prolapse with a laparoscopic trans-abdominal approach is well-established and has resulted in reduced morbidity and shorter hospital stay. It is also well-tolerated in the elderly and shows an improvement in incontinence and a low recurrence rate. This procedure can be enhanced by using a purely anterior (ventral) approach. The dissection is kept anterior to the rectum, by opening the rectovaginal septum and then continuing down to the pelvic floor where a mesh rectopexy is then performed. This avoids posterior rectal dissection and spares the autonomic pelvic nerves; it keeps morbidity low and improves constipation.
Laparoscopic sigmoidectomy with ventral and posterior indirect rectopexy for rectal prolapse in a female patient
Rectal prolapse is an uncommon disease mainly seen in patients of advanced age.
In the last few years, the laparoscopic route has been shown to be feasible and has the advantage of being a minimally invasive technique. The objective of this film is to demonstrate a technique for the repair of rectal prolapse with sigmoidectomy. This is the case of a 72-year-old woman with a previous history of hysterectomy presenting also with dyschezia and moderate incontinence and a grade III rectal prolapse. Defecography showed a prolapse of the upper rectum with an enterocele without any associated rectocele in spite of the hysterectomy.
J Leroy, D Mutter, F Costantino, J Marescaux
Surgical intervention
9 years ago
2473 views
135 likes
0 comments
10:26
Laparoscopic sigmoidectomy with ventral and posterior indirect rectopexy for rectal prolapse in a female patient
Rectal prolapse is an uncommon disease mainly seen in patients of advanced age.
In the last few years, the laparoscopic route has been shown to be feasible and has the advantage of being a minimally invasive technique. The objective of this film is to demonstrate a technique for the repair of rectal prolapse with sigmoidectomy. This is the case of a 72-year-old woman with a previous history of hysterectomy presenting also with dyschezia and moderate incontinence and a grade III rectal prolapse. Defecography showed a prolapse of the upper rectum with an enterocele without any associated rectocele in spite of the hysterectomy.
Laparoscopic indirect ventral rectopexy with sigmoidectomy for rectal prolapse in a young female patient
The aim of surgical treatment of rectal prolapse is to anatomically restore prolapse and functionally remedy fecal incontinence and disorder of rectal emptying. There is not yet sufficient evidence-based knowledge of the advantages and disadvantages of various surgical methods. In practice, trans-abdominal surgery is recommended for patients in good conditions and perineal surgery for elderly and frail patients suffering from associated diseases. The progress of laparoscopic surgery has, however, made the trans-abdominal operation possible also for those in increasingly poor condition. With this procedure a significant improvement of defecation disorder is achieved in over 80% of patients. This video demonstrates the laparoscopic management of a rectal prolapse associated with constipation and a posterior enterocele.
J Leroy, J Marescaux
Surgical intervention
9 years ago
3290 views
140 likes
0 comments
15:44
Laparoscopic indirect ventral rectopexy with sigmoidectomy for rectal prolapse in a young female patient
The aim of surgical treatment of rectal prolapse is to anatomically restore prolapse and functionally remedy fecal incontinence and disorder of rectal emptying. There is not yet sufficient evidence-based knowledge of the advantages and disadvantages of various surgical methods. In practice, trans-abdominal surgery is recommended for patients in good conditions and perineal surgery for elderly and frail patients suffering from associated diseases. The progress of laparoscopic surgery has, however, made the trans-abdominal operation possible also for those in increasingly poor condition. With this procedure a significant improvement of defecation disorder is achieved in over 80% of patients. This video demonstrates the laparoscopic management of a rectal prolapse associated with constipation and a posterior enterocele.