Abstract
Five women aged 64–81 years with complete rectal prolapse and incontinence were treated by laparoscopic mobilization of the rectum and posterior fixation to the presacral fascia using Marlex mesh. Mobilization was carried out with standard straight laparoscopic instruments in the first two patients (operating times 3·5 and 4·5 h) and with coaxial curved instruments and ultrasonic dissection in the succeeding three (operating times 2·5, 2·0 and 2·5 h). Restoration to full continence (grade 1) was observed in two patients and to grade 2 in a further two. No recurrence of the prolapse occurred during follow-up of 4–27 months.
Contributor Information
A Cuschieri, Department of Surgery, Ninewells Hospital and Medical School, University of Dundee, Dundee DD1 9SY, UK.
S M Shimi, Department of Surgery, Ninewells Hospital and Medical School, University of Dundee, Dundee DD1 9SY, UK.
G Vander Velpen, Department of Surgery, Ninewells Hospital and Medical School, University of Dundee, Dundee DD1 9SY, UK.
S Banting, Department of Surgery, Ninewells Hospital and Medical School, University of Dundee, Dundee DD1 9SY, UK.
R A B Wood, Department of Surgery, Ninewells Hospital and Medical School, University of Dundee, Dundee DD1 9SY, UK.
References
- 1. Browning GGP, Parks AG. Postanal repair for neuropathic faecal incontinence: correlation of clinical result and anal pressures. Br J Surg 1983; 70: 101–4. [DOI] [PubMed] [Google Scholar]
- 2. Parks AG, Swash M, Urich H. Sphincter denervation in anorectal incontinence and rectal prolapse. Gut 1977; 18: 656–65. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 3. Wyatt AP. Perineal rectopexy for rectal prolapse. Br J Surg 1981; 68: 717–31. [DOI] [PubMed] [Google Scholar]
- 4. Ripstein CB. Treatment of massive rectal prolapse. Am J Surg 1952; 83: 68–71. [DOI] [PubMed] [Google Scholar]
- 5. Wells C. New operation for rectal prolapse. Proc R Soc Med 1959; 52: 602–3. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 6. Penfold JCB, Hawley PR. Experience of Ivalon sponge implant for complete rectal prolapse at St Mark's Hospital. Br J Surg 1972; 59: 846–8. [DOI] [PubMed] [Google Scholar]
- 7. Frykman HM, Goldberg SM. The surgical treatment of procidentia. Surg Gynecol Obstel 1969; 129: 1225–30. [PubMed] [Google Scholar]
- 8. Cuschieri A, Shimi S, Banting S, Vander Velpen G, Dunkley P. Coaxial curved instrumentation for minimal access surgery. Surg Enclose 1993; 1: 76–81. [PubMed] [Google Scholar]
- 9. Cuschieri A, Shimi S, Banting S, Vander Velpen G.Endoscopic ultrasonic dissection for thoracoscopic and laparoscopic surgery. Surg Endosc 1993. (in press). [DOI] [PubMed] [Google Scholar]
- 10. Sayfan J, Pinho M, Alexander-Williams J, Keighley MRB. Sutured abdominal rectopexy with sigmoidectomy compared to Marlex rectopexy. Br J Surg 1990; 77: 143–5. [DOI] [PubMed] [Google Scholar]
- 11. Duthie GS, Bartolo DCC. Abdominal rectopexy for rectal prolapse: a comparison of techniques. Br J Surg 1992; 79: 107–13. [DOI] [PMC free article] [PubMed] [Google Scholar]