Resection rectopexy for rectal prolapse - The laparoscopic approach

Background: Resection rectopexy through open laparotomy is an established p rocedure for the treatment of rectal prolapse. Methods: Resection rectopexy was successfully performed in 10 multiparous w omen by the laparoscopic approach (LAP), and the results were compared to t hose of eight women with laparotomy resection rectopexy (OPEN). Preoperativ e and postoperative assessment included anorectal manometry, defecography, and measurement of large-bowel transit. Results: The duration of the operation was longer in the LAP than in the OP EN group (p < 0.01). Morbidity was lower (p < 0.01) and hospital stay was s horter (p < 0.001) after the LAP than in the OPEN group. Prolapse was cured in all cases. Postoperatively, anal resting and squeeze pressures and rect al compliance increased significantly in both groups of patients (p = 0.007 , p = 0.003, and p < 0.001, respectively). In all patients, the operation r esulted in acceleration of large-bowel transit (p< 0.001) and in more obtus e anorectal angles at rest (p = 0.007). In addition, sampling events were o bserved more commonly (p 0.008) postoperatively. Preoperatively, incontinen ce was present in 13 patients (seven LAP and six OPEN) and persisted in fou r of them after rectopexy (two LAP and two OPEN). Conclusions: Resection rectopexy for rectal prolapse can be performed safel y via the laparoscopic route. Recovery is uneventful and of shorter duratio n after the laparoscopic than after the open approach. Similarly satisfacto ry functional results are obtained with both procedures.