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A suture rectopexy is essentially the same as a Marlex rectopexy, except that the rectum is fixed to the presacral fascia with suture material rather than mesh. This Video demonstrates suture rectopexy performed at World Laparoscopy Hospital. The overall success rate for recurrent rectal prolapse was 85.2 percent. Conclusion: The outcome of surgery for rectal prolapse is similar in cases of primary or recurrent prolapse. The same surgical options are valid in both scenarios.
Suture Rectopexy for Rectal Prolapse: A Surgical Approach to Restoring Bowel Function
Rectal prolapse is a debilitating condition where the rectum loses its normal attachment inside the pelvis and protrudes through the anus. It can lead to discomfort, fecal incontinence, constipation, and a significantly reduced quality of life. One of the surgical treatments for this condition is suture rectopexy, a procedure aimed at securing the rectum in its proper anatomical position without the use of mesh.
Understanding Suture Rectopexy
Suture rectopexy is a minimally invasive or open surgical procedure in which sutures are used to fix the rectum to the sacrum, preventing further prolapse. Unlike mesh rectopexy, which involves synthetic implants, suture rectopexy relies solely on strong sutures to reposition and stabilize the rectum. This technique reduces complications related to foreign material, such as infections and adhesions, making it a preferred option for certain patient populations.
Surgical Technique
The procedure can be performed using either an open abdominal approach or a laparoscopic/robot-assisted approach, with the latter being preferred due to reduced postoperative pain and faster recovery. The key steps involved in suture rectopexy include:
- Exposure and Mobilization: The rectum is carefully mobilized to allow for repositioning.
- Suture Placement: Strong, non-absorbable sutures are placed between the rectum and the sacral promontory to secure the rectum in place.
- Tension-Free Fixation: Ensuring the rectum is anchored without excessive tension to avoid complications such as chronic pain or recurrence.
- Closure: The abdominal incisions are closed, and recovery begins.
- Avoidance of Mesh-Related Complications: Reduces the risk of mesh erosion, infection, and chronic pain.
- Lower Risk of Constipation: Compared to mesh-based techniques, this procedure may have a lower incidence of postoperative constipation.
- Faster Recovery: When performed laparoscopically, patients experience less postoperative discomfort and a shorter hospital stay.
- Long-Term Efficacy: Studies indicate that suture rectopexy provides good long-term outcomes with low recurrence rates when performed correctly.
While generally safe, suture rectopexy does carry some risks, including:
- Recurrence of Prolapse: Although rare, prolapse can recur if the sutures fail or if there is significant pelvic floor dysfunction.
- Infection or Bleeding: As with any surgical procedure, there is a risk of postoperative infection or bleeding.
- Bowel Dysfunction: Some patients may experience changes in bowel habits, including constipation or urgency.
Suture rectopexy is an effective and safe surgical technique for treating rectal prolapse, particularly in patients who wish to avoid mesh-based procedures. With careful patient selection and proper surgical technique, this approach offers excellent functional outcomes and a significant improvement in quality of life. Patients should consult with their colorectal surgeon to determine the most suitable treatment option based on their individual condition and medical history.
Contact us:World Laparoscopy Hospital
Cyber City, Gurugram, NCR Delhi, INDIA
Phone/WhatsApp: +919811416838, +919999677788
World Laparoscopy Training Institute
Bld. No: 27, DHCC, Dubai, UAE
Phone: +971525857874
World Laparoscopy Training Institute
8320 Inv Dr, Tallahassee, Florida, USA
Phone: +1 321 250 765
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