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VENTRAL MESH RECTOPEXY IN A SPECIALIZED COLO-RECTAL UNIT
Francesco Palmieri
*, Luca Manfrino, muhammad mansour, annalisa coppola, Claudio Missaglia, Andrea Vignali, Alessandra Pecoraro, Pietro Felisatti, Ludovica Bonelli, Diamante Pessina, Pierpaolo Sileri
IRCCS Ospedale San Raffaele, Milan, Lombardy, Italy
Background. Ventral mesh rectopexy (VMR) is a well-established procedure for treating internal or external rectal prolapse. Over the las 2 decades, several issues have been discussed such as right indications, type of mesh, short and longer terms outcomes variability and, more recently, the advantages of a robotic approach. In this study we report our experience with minimally invasive VMR either laparoscopic or robotic and with different use meshes.
Methods. Prospectively collected data on patients who underwent VMR at our recently established colorectal unit were analyzed. Indications, type of approach, type of mesh (polypropylene or biosynthetic) as well as short term results are reported.
Results. A total of 76 VMR were performed since November 2022. All patients were females with a mean age of 59 years (range 19 – 89): 12.7% with external prolapse and 87.7% with internal prolapse. 6.2 % patients had concomitant middle compartment prolapse, while 35.8% concomitant anterior compartment prolapse, 5.2% had all 3 compartments prolapse. 59 were laparoscopic while 16 were robotic. Polypropylene mesh was used in 67, biosynthetic mesh in 6 patients, titanium mesh in 3. Non conversion rate was experienced as well as intraoperative or postoperative complications. No difference among type of approach or type of mesh. Short term functional results show overall improvement of the symptoms and no recurrence of the prolapse.
Conclusions. Confirming that VMR is a safe and effective procedure, we believe that robotic approach relates to less post-operative pain and better quality of life score at the follow up.
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