Our Summary
This research looks at the results of repeat surgeries, specifically those done with a robot, in patients who had a type of surgery called ventral mesh rectopexy (VMR). VMR is a minimally invasive procedure used for fixing a condition called rectal prolapse, where the rectum slides out of place. The study specifically looks at patients who had to have a second surgery because their rectal prolapse came back, they had mesh erosion (where the mesh used in the surgery starts to break down), or they had pelvic pain.
The researchers analyzed data from surgeries done between 2011 and 2019 and divided the repeat surgeries into groups based on why they were needed. They looked at complications that happened during surgery and within the 90 days after surgery.
They found that the complications from repeat surgeries for recurrent prolapse were similar to the complications from the first VMR surgery. However, repeat surgeries for mesh erosion had more complications both during and after surgery compared to the first VMR. Repeat surgeries for pelvic pain also had complications, and only half of these patients had their pain relieved after surgery.
In conclusion, having a second surgery for recurrent rectal prolapse is safe. However, having a second surgery for mesh erosion comes with a higher risk of complications. Having a second surgery for pelvic pain can also have major complications and only works for half of the patients.
FAQs
- What is ventral mesh rectopexy (VMR) surgery?
- What are the risks associated with repeat surgeries for mesh erosion and pelvic pain after VMR surgery?
- Are the complications from repeat surgeries for recurrent prolapse similar to the first VMR surgery?
Doctor’s Tip
A doctor might advise a patient undergoing rectal prolapse surgery to carefully follow post-operative instructions to reduce the risk of complications and promote a successful outcome. This may include avoiding heavy lifting, following a specific diet to prevent constipation, and taking prescribed medications as directed. Additionally, it’s important to attend follow-up appointments with your healthcare provider to monitor healing and address any concerns promptly.
Suitable For
Overall, patients who are recommended rectal prolapse surgery are those who have recurrent rectal prolapse, mesh erosion, or pelvic pain that is not improving with conservative treatments. These patients may experience discomfort, difficulty with bowel movements, and other symptoms that significantly impact their quality of life. It is important for patients to discuss their symptoms and treatment options with their healthcare provider to determine if surgery is the best course of action for their specific situation.
Timeline
Before rectal prolapse surgery, a patient may experience symptoms such as rectal bleeding, pain during bowel movements, a feeling of incomplete emptying after bowel movements, or a protrusion of tissue from the rectum. They may undergo diagnostic tests such as a physical examination, colonoscopy, or imaging studies to confirm the diagnosis of rectal prolapse.
After rectal prolapse surgery, the patient will typically experience some pain and discomfort at the surgical site, which can be managed with pain medication. They may also experience changes in bowel habits, such as constipation or diarrhea, as the body adjusts to the surgery. The patient will need to follow post-operative instructions from their surgeon, which may include dietary changes, activity restrictions, and follow-up appointments.
Overall, the goal of rectal prolapse surgery is to correct the prolapse and improve the patient’s quality of life. It is important for patients to discuss the potential risks and benefits of surgery with their healthcare provider to make an informed decision about their treatment options.
What to Ask Your Doctor
Some questions a patient should ask their doctor about rectal prolapse surgery include:
- What are the potential risks and complications associated with rectal prolapse surgery, particularly for repeat surgeries?
- What is the success rate of repeat surgeries for recurrent rectal prolapse, mesh erosion, and pelvic pain?
- How long is the recovery process for rectal prolapse surgery, and what can I expect in terms of pain and discomfort?
- Are there any alternative treatments or therapies available for rectal prolapse that I should consider before opting for surgery?
- How experienced are you in performing rectal prolapse surgeries, particularly repeat surgeries, and what is your success rate?
- Will I need to undergo any additional tests or evaluations before scheduling the surgery?
- What type of anesthesia will be used during the surgery, and what are the potential side effects or risks associated with it?
- How long will the effects of the surgery last, and are there any lifestyle changes I should make to prevent the recurrence of rectal prolapse in the future?
- Are there any long-term complications or risks associated with rectal prolapse surgery that I should be aware of?
- Can you provide me with more information about the specific technique or approach you will be using for the surgery, and how it differs from other options available?
Reference
Authors: van der Schans EM, Verheijen PM, Broeders IAMJ, Consten ECJ. Journal: Colorectal Dis. 2021 Dec;23(12):3205-3212. doi: 10.1111/codi.15979. Epub 2021 Nov 16. PMID: 34741395