LAPAROSCOPIC RECTOPEXY FOR COMPLETE RECTAL PROLAPSE - CLINICAL OUTCOME AND ANORECTAL FUNCTION-TESTS

Background: The purpose of this study was to evaluate the clinical out come of laparoscopic rectopexy and its effect on anorectal function in vestigations. Methods: Twelve patients with complete rectal prolapse w ithout constipation underwent laparoscopic rectopexy. Pre- and postope rative evaluation included scoring of incontinence, anorectal manometr y, and anal endosonography. Results: No recurrences of rectal prolapse were seen (median follow-up 19 months). Continence improved in eight of nine preoperatively incontinent patients. Two patients had mild con stipation after surgery. Median maximum basal pressure measured by ano rectal manometry increased from 20 to 25 mmHg (p = 0.005) and the rect oanal inhibitory reflex improved in seven patients (p = 0.03). Rectal sensitivity did not change significantly. Endosonography showed asymme try and thickening of the internal anal sphincter and submucosa preope ratively. After surgery the maximum internal anal sphincter thickness decreased from 3.0 mm to 2.6 mm (p = 0.02). Conclusions: Laparoscopic rectopexy improved continence in our patients. Anorectal function test s show a partial recovery of the internal anal sphincter. Laparoscopic rectopexy combines the low morbidity of minimal invasive surgery with the good outcome of abdominal rectopexy.