Laparoscopic Mesh Repair of Pelvic Organ Prolapse

The laparoscopic repair of rectal prolapse has been well described. Patients with rectal prolapse often, if properly evaluated, will have a concomitant anterior pelvic dysfunction. We present the video of a 69-year-old female with a history of rectal prolapse that underwent a perineal proctectomy only to recur within a year of surgery. On exam she was found to have recurrent rectal prolapse but also noted was a degree of vaginal vault prolapse. After an evaluation by a multidisciplinary team a combined laparoscopic approach was undertaken.

Anterior rectal fixation for the treatment of rectal prolapse is gaining increasing acceptance due to its effectiveness and reported decrease in defecation disorders that often accompanies a complete posterior approach. This anterior approach has additional appeal in combination with a colpopexy, as a single piece of mesh can be utilized to fix both the rectum and posterior vaginal wall.

The combined procedure was performed in less than 2 hours and the patient was discharged home in 2 days. At a 3-month follow up all of her symptoms have resolved and she requires only a daily bulk laxative to achieve a bowel movement.

Session: Podium Presentation

Program Number: V014

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