Laparoscopic Rectopexy for Rectal Prolapse in Children

Abstract

Recently the laparoscopic approach has been applied to rectal prolapse as a less invasive procedure in adults. However, there have been few reports of these laparoscopic procedures in children. We performed laparoscopic suture rectopexy in three children, two of whom had an associated developmental disorder. After the retrorectal dissection, the rectum was fixed to the presacral fascia with four 2-0 braided absorbable sutures. Additionally, oxycellulose was left in the retrorectal space as an adhesive and hemostatic agent. The postoperative course was uneventful. In two cases, the results remain good after follow-up of 18 and 27 months. In the remaining case, rectal prolapse recurred after 5 months, and eventually resection rectopexy was needed 1 year after the initial operation. Our experience shows that laparoscopic suture rectopexy is feasible and less invasive in children, as it is in adults. In selected cases, laparoscopic rectopexy could be the primary surgical intervention for the treatment of full-thickness rectal prolapse.