title: A novel technique of introducing the mesh at the distal dissection while performing laparoscopic ventral rectopexy.
abstract: OBJECTIVE
  Laparoscopic ventral rectopexy (LVR) is considered an effective treatment for rectal prolapse and/or rectoanal intussusception. After the dissection of the rectovaginal septum down to the pelvic floor, a strip of mesh is introduced and should be secured as distally as possible. We have developed a novel technique of introducing the mesh at the distal dissection.
  
  
  METHODS
  A nylon thread with straight needle was passed through the posterior wall of vagina at the distal extent of the dissection, which was caught in the abdominal cavity and fixed at the end of the mesh extracorporeally. The mesh was then introduced, pulled toward the pelvic floor and settled at the pierced site by the perineal operator.
  
  
  RESULTS
  Sixty-eight female patients underwent LVR using this technique. There were no intra-operative and postoperative mesh-related complications. The mean distance from the vaginal ostium to the point of passing a nylon thread through the posterior wall of the vagina was 2 cm. Postoperative proctography showed the anatomical correction in 47 of the 48 patients who were examined.
  
  
  CONCLUSIONS
  The surgeon can confirm that the mesh is introduced and secured at the distal dissection by using this technique while performing LVR.
authors.affiliation: Department of Gastroenterological Surgery, Kameda Medical Center, Kamogawa City, Japan.
authors.forename: A
authors.initials: A
authors.lastname: Tsunoda
authors.affiliation: Department of Gastroenterological Surgery, Kameda Medical Center, Kamogawa City, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Takahashi
authors.affiliation: Department of Gastroenterological Surgery, Kameda Medical Center, Kamogawa City, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Ohta
authors.affiliation: Department of Gastroenterological Surgery, Kameda Medical Center, Kamogawa City, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Kusanagi
mesh_terms: D013505:Digestive System Surgical Procedures / Q000379:methods*; D005260:Female; D006801:Humans; D007443:Intussusception / Q000601:surgery*; D012002:Rectal Diseases / Q000601:surgery; D012005:Rectal Prolapse / Q000601:surgery*; D013526:Surgical Mesh; D013536:Suture Techniques; D016896:Treatment Outcome; D014621:Vagina
keywords: Laparoscopic ventral rectopexy; mesh introduction; postoperative proctography