Introduction: What does Laparoscopic Ventral Mesh Rectopexy mean?

 

This is a keyhole operation that hitches up the rectum and sometimes the vagina using sutures and mesh.                  

                      

When is LVMR performed?
This operation is most commonly performed for patients with  external rectal prolapse (that is when the rectum has turned itself out and hangs outside) or internal rectal prolapse (when the rectum has telescoped into itself but has remained within the body) causing obstructed defecation syndrome (ODS). Both of these conditions could also cause incontinence as the predominant symptom.

 

How are patients prepared for the operation?
You may have one or more of the following investigations to obtain more information and ensure the operation is right for you:

 

1. Flexible sigmoidoscopy/ Colonoscopy

2. Defaecating proctogram

3. Transit studies

4. Anorectal physiology

5. Endoanal ultrasound.

 

You will attend a pre-assessment appointment prior to your admission for surgery. This is to check that the anaesthetic will be safe for you and to carry out any further tests that are necessary. You will then usually come up to hospital on the morning of the operation.

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How is LVMR performed?

You will be given an enema on the morning of surgery. The operation is performed under general anaesthetic by keyhole surgery. The surgeon opens up the space between the rectum and vagina; then opens up the peritoneum (the thin layer that lines our insides) alongside the rectum. By operating only in front of the rectum, the surgeon stays away from the nerves supplying the bowel and genitalia. A piece of mesh is stitched to the front of the rectum and this mesh is in turn secured to the sacrum (lower backbone) pulling the bowel up out of the pelvis and preventing it from telescoping down. This restores the rectum it to its normal anatomical position.