RESUMO
Objective: To find out the short term outcomes of effectiveness and safety of laparoscopic ventral rectopexy for rectal prolapsed
Methods: It was a descriptive case series study of 31 consecutive patients of rectal prolapse in Colorectaldivision of Ward 2, Department of General surgery, Jinnah Post Graduate Medical Center, Karachi, from November 2009 to November 2015. These patients were admitted through outpatient department with complains of something coming out of anus, constipation and per rectal bleeding. All patients were clinically examined and baseline investigations were done. All patients underwent laparoscopic repair with ventral mesh placement on rectum
Results: Among 31 patients, mean age was 45 years range [20 - 72]. While females were 14[45%] and males 17[55%]. We observed variety of presentations, including solitary rectal ulcers [n=4] and rectocele [n=3] but full thickness rectal prolapse was predominant [n=24]. All patients had laparoscopic repair with mesh placement. Average hospital stay was three days. Out of 31 patients, there was one [3.2%] recurrence
Port site minor infection in 3[9.7%] patients, while conversion to open approach was done in two [6.4%], postoperative ileus observed in two [6.4%] patients
One[3.2%] patient developed intractable back pain and mesh was removed six weeks after the operation. One[4.8%] patient complained of abdominal pain off and on postoperatively. No patient developed denovo or worsening constipation while constipation was improved in 21 patients [67%]. Sexual dysfunction such as dysperunia in females and impotence in males was not detected in follow up
Conclusions: This study provides the limited evidence that nerve sparing laparoscopic ventral rectopexy is safe and effective treatment of external and symptomatic internal rectal prolapse. It has better cosmetic and functional outcome as advantages of minimal access and comparable recurrence rate
RESUMO
To find out the short term outcomes of laparoscopic ventral hernia repair [LVHR] during the last four years. It was a descriptive and prospective case series of 53 consecutive patients out of 107 at Department of General Surgery, Jinnah Post Graduate Medical Center, Unit II, Karachi, from January 2009 to December 2012. These patients were admitted through out patient department with complain of lump, pain and discomfort. Most of the patients were obese. All patients were clinically examined and baseline investigations done. Fifty three [49.5%] patients underwent laparoscopic repair with mesh placement and remaining 54 by open surgical repair. Among 53 patients, mean age was 46 years range [30 - 55]. While females were 33[62.2%] and males 20[37.7%]. We observed variety of hernias, in which midline and epigastric hernia were predominant. The commonest symptom was lump and dragging sensation. The duration of symptoms ranged between 6 months to one year. About 53 patients [49.5%] had laparoscopic repair with mesh placement. Average hospital stay was two days. Out of 53 patients, 4 [7.5%] had cellulitis at trocar site, seroma in 2[3.7%], 2[3.7%] patient complained of persistent pain postoperatively, port site minor infection was in 2[3.7%] patients, while conversion to open approach was done in 2 [3.7%], postoperative ileus was observed in one [1.8%] patients. This study provides the evidence that, laparoscopic repair with mesh placement in ventral hernia is safe and effective approach compared to open surgical procedure. It has a low complication rate, less hospital stay and low recurrence