Laparoscopic ventral rectopexy for obstructed defecation syndrome |
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Authors: | J. W. van den Esschert A. A. W. van Geloven N. Vermulst A. Groenedijk L. Th. de Wit M. F. Gerhards |
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Affiliation: | (1) Department of Surgery, Tergooi Ziekenhuizen, Van Riebeeckweg 212, Hilversum, 1213 XZ, The Netherlands;(2) Department of Surgery, St. Franciscus Gasthuis, Rotterdam, The Netherlands;(3) Department of Gynaecology, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands;(4) Department of Surgery, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands |
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Abstract: | Introduction Obstructed defecation remains a serious syndrome. Several procedures have been applied to treat it. A concomitant enterocele excludes some of these procedures, because of potential threat of damaging the bowel. The aim of this study was to assess the outcome of patients who underwent laparoscopic nerve sparing ventral rectopexy for obstructed defecation syndrome with concomitant enterocele. Methods Seventeen patients were included. Data about clinical history, physical examination and a defecogram were collected. All patients underwent a laparoscopic ventral rectopexy. Complications, hospital stay, postoperative morbidity and long-term outcome were documented. Results All patients underwent laparoscopic ventral rectopexy. The median operating time was 199 min (range 186–239 min). One conversion laparotomy was required. Six patients had postoperative complications (ileus n = 2, posttraumatic leg dystrophy n = 1, wound infection n = 1, incisional hernia n = 2). The median hospital stay was 6 days (range 3–24 days). Fifteen patients had improvement of their defecation problem, although six patients still had minor constipation symptoms. In one patient the mesh was rejected and finally removed. Conclusion Obstructed defecation syndrome is a combined functional and mechanical problem. In selected patients, especially when an enterocele is present, laparoscopic ventral rectopexy is a feasible technique, with an acceptable number of complications. An erratum to this article can be found at |
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Keywords: | Obstructed defecation syndrome Laparoscopy Rectopexy Enterocele |
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