• Skip to main content
  • Skip to header right navigation
  • Skip to site footer

Log in
  • Search
    • Search All SAGES Content
    • Search SAGES Guidelines
    • Search the Video Library
    • Search the Image Library
    • Search the Abstracts Archive
www.sages.org

SAGES

Reimagining surgical care for a healthier world

  • Home
    • Search
    • SAGES Home
    • SAGES Foundation Home
  • About
    • Awards
    • Who Is SAGES?
    • Leadership
    • Our Mission
    • Advocacy
    • Committees
      • SAGES Board of Governors
      • Officers and Representatives of the Society
      • Committee Chairs and Co-Chairs
      • Committee Rosters
      • SAGES Past Presidents
  • Meetings
    • SAGES NBT Innovation Weekend
    • SAGES Annual Meeting
      • 2026 Scientific Session Call for Abstracts
      • 2026 Emerging Technology Call for Abstracts
    • CME Claim Form
    • SAGES Past, Present, Future, and Related Meeting Information
    • SAGES Related Meetings & Events Calendar
  • Join SAGES!
    • Membership Application
    • Membership Benefits
    • Membership Types
      • Requirements and Applications for Active Membership in SAGES
      • Requirements and Applications for Affiliate Membership in SAGES
      • Requirements and Applications for Associate Active Membership in SAGES
      • Requirements and Applications for Candidate Membership in SAGES
      • Requirements and Applications for International Membership in SAGES
      • Requirements for Medical Student Membership
    • Member Spotlight
    • Give the Gift of SAGES Membership
  • Patients
    • Join the SAGES Patient Partner Network (PPN)
    • Patient Information Brochures
    • Healthy Sooner – Patient Information for Minimally Invasive Surgery
    • Choosing Wisely – An Initiative of the ABIM Foundation
    • All in the Recovery: Colorectal Cancer Alliance
    • Find A SAGES Surgeon
  • Publications
    • Clinical / Practice / Training Guidelines, Statements, and Standards of Practice
    • Sustainability in Surgical Practice
    • SAGES Stories Podcast
    • Patient Information Brochures
    • Patient Information From SAGES
    • TAVAC – Technology and Value Assessments
    • Surgical Endoscopy and Other Journal Information
    • SAGES Manuals
    • MesSAGES – The SAGES Newsletter
    • COVID-19 Archive
    • Troubleshooting Guides
  • Education
    • Wellness Resources – You Are Not Alone
    • Avoid Opiates After Surgery
    • SAGES Subscription Catalog
    • SAGES TV: Home of SAGES Surgical Videos
    • The SAGES Safe Cholecystectomy Program
    • Masters Program
    • Resident and Fellow Opportunities
      • MIS Fellows Course
      • SAGES Robotics Residents and Fellows Courses
      • SAGES Free Resident Webinar Series
      • Fluorescence-Guided Surgery Course for Fellows
      • Fellows’ Career Development Course
    • SAGES S.M.A.R.T. Enhanced Recovery Program
    • SAGES @ Cine-Med Products
      • SAGES Top 21 Minimally Invasive Procedures Every Practicing Surgeon Should Know
      • SAGES Pearls Step-by-Step
      • SAGES Flexible Endoscopy 101
    • SAGES OR SAFETY Video Activity
  • Opportunities
    • Fellowship Recognition Opportunities
    • SAGES Advanced Flexible Endoscopy Area of Concentrated Training (ACT) SEAL
    • Multi-Society Foregut Fellowship Certification
    • Research Opportunities
    • FLS
    • FES
    • FUSE
    • Jobs Board
    • SAGES Go Global: Global Affairs and Humanitarian Efforts
  • OWLS/FLS
You are here: Home / Abstracts / A prospective study beyond the RCT between our modified Ripstein method and modified Wells method for complete rectal prolapse

A prospective study beyond the RCT between our modified Ripstein method and modified Wells method for complete rectal prolapse

Tokihito Nishida, PhD, Hajime Ikuta, PhD, Kunio Yokoyama, PhD, Takuya Kudo, MD. Department of Surgery, Kasai City Hospital, Hyogo, Japan

Background: For the complete rectal prolapse (basically longer than 3cm), we thought sling rectopexy was most reasonable to hang up and fix the rectum, which drooped down and prolapsed due to the relaxation of supporting tissue. We considered Ripstein method had enough fixed power of rectum to sacrum. However, complications of rectal stenosis, constipation, mesh infection and mesh penetration were reported. Therefore, we modified Ripstein method to conquer such complications.

Aim: A prospective study beyond the randomized control trial (RCT) between our modified (m)-Ripstein method and m-Wells methods was performed to evaluate feasibility and efficacy of our m-Ripntein method.

Materials and Methods: From December 2007 to August 2017, 79 rectopexies for complete rectal prolapse were assigned to RCT. To prevent the complication of original Ripstein method, we devised to set the horizontal length of T style BARDTM mesh up to almost 1.2 fold of rectal circumference for loose fit, and prolong the vertical length of the mesh to almost 2 fold of the original for straight fit. Mesh was fixed to rectum with Endo Universal StaplerTM and to sacrum with AbsorbaTackTM. When each 25 cases were registered to RCT, second recurrence of m-Wells method occurred. We stopped m-Wells method until the cause would be clear and continued m-Ripstein method to 51 cases. After the cause of recurrence by m-Wells method was revealed, it was resumed to 28 cases.

Results: Patient’s characteristics (average value) in m-Ripstein 51 cases vs. m-Wells 28 cases were not significantly different; age 79.1 vs. 78.9-year-old, female 86.3 vs. 85.7%, BMI 21.7 vs. 21.1, length of prolapse 4.7 vs. 4.3cm, comorbidities number per patient 4.4 vs.4.8 and ASA-PS 2.6 vs. 2.6. In clinical outcomes (average value), operative time was 164 vs. 143 minutes (P=0.0318) and the others; blood loss 33 vs. 11 grams, intraoperative accident 18 vs. 7%, postoperative complication 9.8 vs. 3.6%, mesh infection/morbidity 0 vs. 0 %, meal start 1.9 vs. 1.9POD, postoperative constipation 14 vs. 14%, postoperative fecal incontinence 7.8 vs. 0%, postoperative urinary incontinence 5.9 vs. 0%, postoperative stay 9.4 vs.9.0 days, follow up interval 39 vs. 31 months and recurrence rate 0 vs. 7.1 % were not significantly different.   

Conclusion: Primary evaluation item of recurrence rate were not significantly different. Secondary evaluation items of postoperative constipation, fecal incontinence and urinary incontinence were not significantly different between two groups. Our m-Ripstein method was feasible and showed good outcome especially in recurrence. 


Presented at the SAGES 2017 Annual Meeting in Houston, TX.

Abstract ID: 87567

Program Number: P223

Presentation Session: iPoster Session (Non CME)

Presentation Type: Poster

96

Share this:

  • Click to share on X (Opens in new window) X
  • Click to share on Facebook (Opens in new window) Facebook
  • Click to share on LinkedIn (Opens in new window) LinkedIn
  • Click to share on Pinterest (Opens in new window) Pinterest
  • Click to share on WhatsApp (Opens in new window) WhatsApp
  • Click to share on Reddit (Opens in new window) Reddit
  • Click to share on Pocket (Opens in new window) Pocket
  • Click to share on Mastodon (Opens in new window) Mastodon
  • Click to share on Threads (Opens in new window) Threads
  • Click to share on Bluesky (Opens in new window) Bluesky

Related


sages_adbutler_leaderboard

Hours & Info

11300 West Olympic Blvd, Suite 600
Los Angeles, CA 90064

1-310-437-0544

[email protected]

Monday – Friday
8am to 5pm Pacific Time

Find Us Around the Web!

  • Bluesky
  • X
  • Instagram
  • Facebook
  • YouTube

Copyright © 2025 · SAGES · All Rights Reserved

Important Links

Healthy Sooner: Patient Information

SAGES Guidelines, Statements, & Standards of Practice

SAGES Manuals