Ventral rectopexy

Ventral rectopexy is a surgical procedure used for external rectal prolapse and internal rectal prolapse (rectal intussusception), and sometimes for other conditions such as rectocele, obstructed defecation syndrome or solitary rectal ulcer syndrome. The rectum is fixed in its proper position, usually with a biological or synthetic mesh attached to the sacral promontory, which corrects the abnormal descent of the rectum, reinforces its front surface and lifts the pelvic floor. In women it also reinforces the rectovaginal septum and may be combined with sacrocolpopexy. Mesh was first reported for ventral fixation in 1971, the Orr-Loygue lateral mesh rectopexy followed in 1984, and the ventral operation was developed as a modification of it by D'Hoore in 2004, usually done laparoscopically. It is an abdominal rectopexy that avoids posterior and lateral dissection to spare the autonomic nerves, so new or worsened constipation is less of a problem than with older abdominal operations. Reported recurrence runs from 1.4 to 9.7 percent of cases and mesh-related complications are low, but the article notes calls for caution about the rapid rise in its popularity and the limited high-quality evidence. Contraindications include pregnancy, severe abdominal adhesions and active colitis. This entry records what is held about the procedure and is not medical advice.