Wrap technique for rectal prolapse: video step by step.

Abstract

The aim of the present video is to show a new method of fixation using a self-adhesive prosthesis (Adhesix) in laparoscopic ventral rectopexy for the treatment of rectal prolapse. The use of a non-absorbable prosthesis combined with an anterior limited dissection is now well accepted since D’Hoore and Pennickx publication in 2004, with good anatomical and functional results. The recurrence rate is low, but the risk of mesh detachment still exists. However, the main reason why surgeons choose a non-prosthetic technique has to do with complications associated with the prosthetic material. One must admit that the complications associated with prosthesis material (sepsis and erosion), although rare, are potentially serious, especially considering that the surgery is done for functional purposes. These complications are likely to be related either to the type of mesh used or to the technique of fixation (sutures, stitches, staples) on the rectum and the posterior side of the vagina. The goal of our wrap technique with Adhesix is to avoid these problems by carrying out a very low dissection and by using a synthetic self-adhesive prosthesis which coats widely the lower part of the rectum without requiring sutures between the rectum, mesh and vagina. Operative technique step by step