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Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jun 7, 2016; 22(21): 4977-4987
Published online Jun 7, 2016. doi: 10.3748/wjg.v22.i21.4977
Current status of laparoscopic and robotic ventral mesh rectopexy for external and internal rectal prolapse
Jan J van Iersel, Tim J C Paulides, Paul M Verheijen, John W Lumley, Ivo A M J Broeders, Esther C J Consten
Jan J van Iersel, Paul M Verheijen, Tim JC Paulides, Ivo AMJ Broeders, Esther CJ Consten, Meander Medical Centre, Department of Surgery, 3813 TZ Amersfoort, The Netherlands
Jan J van Iersel, Ivo AMJ Broeders, Twente University, Faculty of Science and Technology, Institute of Technical Medicine, 7522 NB Enschede, The Netherlands
John W Lumley, Wesley Medical Centre, Department of Surgery, Auchenflower QLD 4066, Australia
Author contributions: van Iersel JJ and Paulides TJC designed the study, performed the research, analysed the data and drafted the article; Verheijen PM, Lumley JW, Broeders IAMJ and Consten ECJ critically reviewed and revised the manuscript; all authors read and approved the final version of the manuscript.
Conflict-of-interest statement: No conflict of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Esther CJ Consten, MD, PhD, Gastro-intestinal Surgeon, Meander Medical Centre, Department of Surgery, Maatweg 3, 3813 TZ Amersfoort, The Netherlands. ecj.consten@meandermc.nl
Telephone: +31-33-8505050 Fax: +31-33-8502291
Received: March 18, 2016
Peer-review started: March 21, 2016
First decision: March 31, 2016
Revised: April 15, 2016
Accepted: May 4, 2016
Article in press: May 4, 2016
Published online: June 7, 2016
Abstract

External and internal rectal prolapse with their affiliated rectocele and enterocele, are associated with debilitating symptoms such as obstructed defecation, pelvic pain and faecal incontinence. Since perineal procedures are associated with a higher recurrence rate, an abdominal approach is commonly preferred. Despite the description of greater than three hundred different procedures, thus far no clear superiority of one surgical technique has been demonstrated. Ventral mesh rectopexy (VMR) is a relatively new and promising technique to correct rectal prolapse. In contrast to the abdominal procedures of past decades, VMR avoids posterolateral rectal mobilisation and thereby minimizes the risk of postoperative constipation. Because of a perceived acceptable recurrence rate, good functional results and low mesh-related morbidity in the short to medium term, VMR has been popularized in the past decade. Laparoscopic or robotic-assisted VMR is now being progressively performed internationally and several articles and guidelines propose the procedure as the treatment of choice for rectal prolapse. In this article, an outline of the current status of laparoscopic and robotic ventral mesh rectopexy for the treatment of internal and external rectal prolapse is presented.

Keywords: Laparoscopic ventral mesh rectopexy, Robot, Rectal prolapse, External rectal prolapse, Internal rectal prolapse, Rectocele, Mesh erosion, Obstructed defecation, Faecal incontinence, Biological mesh

Core tip: Globally, there is no uniformity for the treatment of internal and external rectal prolapse. Laparoscopic or robotic-assisted ventral mesh rectopexy is being progressively performed internationally for correcting rectal prolapse. This abdominal approach avoids posterolateral rectal mobilization and the risks of an anastomosis, corrects the middle compartment, improves anorectal function and shows acceptable recurrence rates. In this article, a synopsis of the current status of laparoscopic and robotic ventral mesh rectopexy for the treatment of internal and external rectal prolapse is presented.