title: Laparoscopic ventral rectopexy for fecal incontinence associated with high-grade internal rectal prolapse.
abstract: BACKGROUND
  The role of internal rectal prolapse in the origin of fecal incontinence remains to be defined. In our institution, laparoscopic ventral rectopexy is offered to patients with high-grade internal prolapse and fecal incontinence.
  
  
  OBJECTIVE
  The present study was designed to evaluate the functional outcome after laparoscopic ventral rectopexy in patients with fecal incontinence associated with high-grade internal rectal prolapse.
  
  
  METHODS
  This study was designed as a prospective observational study.
  
  
  METHODS
  The study took place in a university hospital.
  
  
  METHODS
  Between 2009 and 2011, 72 patients with fecal incontinence not responding to maximum medical treatment (including biofeedback) were included. All patients had a grade III or grade IV rectal prolapse.
  
  
  METHODS
  Laparoscopic ventral rectopexy was performed.
  
  
  METHODS
  Preoperative endoanal ultrasonography and anorectal manometry were performed. Fecal continence was evaluated by using the Rockwood Fecal Incontinence Severity Index score before and 1 year after surgery.
  
  
  RESULTS
  The median fecal incontinence severity index score 1 year after surgery was lower than the median score before surgery (15 versus 31; p < 0.01), representing an improvement in fecal continence.
  
  
  CONCLUSIONS
  This was a preliminary observational study with no control group, no postoperative proctography, and no postoperative anal physiology.
  
  
  CONCLUSIONS
  Laparoscopic ventral rectopexy can improve symptoms of fecal incontinence in patients with a high-grade internal rectal prolapse. Internal rectal prolapse contributes to the multifactorial origin of fecal incontinence.
authors.affiliation: Oxford Pelvic Floor Centre, Department of Colorectal Surgery, Churchill Hospital, Oxford, United Kingdom.
authors.forename: Martijn P
authors.initials: MP
authors.lastname: Gosselink
authors.forename: S
authors.initials: S
authors.lastname: Adusumilli
authors.forename: Kim J
authors.initials: KJ
authors.lastname: Gorissen
authors.forename: Simona
authors.initials: S
authors.lastname: Fourie
authors.forename: Jurriaan B
authors.initials: JB
authors.lastname: Tuynman
authors.forename: Oliver M
authors.initials: OM
authors.lastname: Jones
authors.forename: Chris
authors.initials: C
authors.lastname: Cunningham
authors.forename: Ian
authors.initials: I
authors.lastname: Lindsey
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001003:Anal Canal / Q000503:physiopathology; D005242:Fecal Incontinence / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods; D008297:Male; D008365:Manometry; D008875:Middle Aged; D011446:Prospective Studies; D012005:Rectal Prolapse / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D012007:Rectum / Q000503:physiopathology / Q000601:surgery*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome