Advertisement

International Urogynecology Journal

, Volume 25, Issue 4, pp 553–555 | Cite as

Robot-assisted rectopexy and colpopexy for rectal prolapse

  • Kristie A. GreeneEmail author
  • Jaime E. Sanchez
  • Michael L. Campbell
  • Jorge E. Marcet
IUJ Video

Abstract

Aim

This video demonstrates a technique for robot-assisted combined rectopexy with colpopexy, but without the use of mesh for rectal prolapse.

Methods

This case features a 61-year-old woman who presents with complaints of tissue protruding through her rectum and fecal incontinence. On examination, she was found to have circumferential, full-thickness rectal prolapse and perineal descent. We present a technique that combines rectopexy with colpopexy without the use of mesh for repair of rectal prolapse. Postoperative examination revealed resolution of rectal prolapse and good perineal support. This video illustrates a technique that may serve as a useful adjunct to have in one’s surgical armamentarium in circumstances when mesh should not or cannot be used, such as in cases that require resection of the sigmoid colon or for patients who simply prefer to avoid the use of mesh.

Conclusion

Given that rectal prolapse and posthysterecomy vaginal vault prolapse often occur together, our institution routinely performs colpopexy with rectopexy for rectal prolapse to provide additional support to the pelvic floor as demonstrated in this video.

Keywords

Rectal prolapse Rectopexy Colpopexy Pelvic organ prolapse Robotic 

Notes

Acknowledgements

Written informed consent was obtained from the patient for publication of this video article and any accompanying images. No financial support was received for this study.

Conflicts of interest

None.

Supplementary material

ESM 1

(MP4 48683 kb)

References

  1. 1.
    Lauretta A et al (2012) Laparoscopic low ventral rectocolpopexy (LLVR) for rectal and rectogenital prolapse: surgical technique and functional results. Tech Coloproctol 16(6):477–483PubMedCrossRefGoogle Scholar
  2. 2.
    Peters WA 3rd, Smith MR, Drescher CW (2001) Rectal prolapse in women with other defects of pelvic floor support. Am J Obstet Gynecol 184(7):1488–1494PubMedCrossRefGoogle Scholar
  3. 3.
    Tou S et al (2008) Surgery for complete rectal prolapse in adults. Cochrane Database Syst Rev 4, CD001758PubMedGoogle Scholar
  4. 4.
    Slawik S et al (2008) Laparoscopic ventral rectopexy, posterior colporrhaphy and vaginal sacrocolpopexy for the treatment of recto-genital prolapse and mechanical outlet obstruction. Colorectal Dis 10(2):138–143PubMedGoogle Scholar
  5. 5.
    Collopy BT, Barham KA (2002) Abdominal colporectopexy with pelvic cul-de-sac closure. Dis Colon Rectum 45(4):522–526, discussion 526–529PubMedCrossRefGoogle Scholar
  6. 6.
    Heah SM et al (2000) Laparoscopic suture rectopexy without resection is effective treatment for full-thickness rectal prolapse. Dis Colon Rectum 43(5):638–643PubMedCrossRefGoogle Scholar
  7. 7.
    Madiba TE, Baig MK, Wexner SD (2005) Surgical management of rectal prolapse. Arch Surg 140(1):63–73PubMedCrossRefGoogle Scholar
  8. 8.
    Marderstein EL, Delaney CP (2007) Surgical management of rectal prolapse. Nat Clin Pract Gastroenterol Hepatol 4(10):552–561PubMedCrossRefGoogle Scholar
  9. 9.
    Melton GB, Kwaan MR (2013) Rectal prolapse. Surg Clin N Am 93(1):187–198PubMedCrossRefGoogle Scholar
  10. 10.
    Popp L, Augustin A (2013) Pelvic floor-lifting: an interdisciplinary repair of combined rectal and vaginal prolapse-5 years experience. Arch Gynecol Obstet 288(1):83–90PubMedCrossRefGoogle Scholar

Copyright information

© The International Urogynecological Association 2013

Authors and Affiliations

  • Kristie A. Greene
    • 1
    • 4
    Email author
  • Jaime E. Sanchez
    • 2
  • Michael L. Campbell
    • 3
  • Jorge E. Marcet
    • 2
  1. 1.Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and GynecologyUniversity of South FloridaTampaUSA
  2. 2.Division of Colon and Rectal Surgery, Department of SurgeryUniversity of South FloridaTampaUSA
  3. 3.Department of SurgeryUniversity of South FloridaTampaUSA
  4. 4.Division of Female Pelvic Medicine and Reconstructive Surgery, College of MedicineUniversity of South FloridaTampaUSA

Personalised recommendations