title: A novel technique for correction of total rectal prolapse: Endoscopic-assisted percutaneous rectopexy with the aid of the EndoLifter.
abstract: OBJECTIVE
  Rectal prolapse is common in the elderly, having an incidence of 1% in patients over 65years of age. The aim of this study was to evaluate the safety and feasibility of a new endoluminal procedure for attaching the previously mobilized rectum to the anterior abdominal wall using an endoscopic fixation device.
  
  
  METHODS
  The study is a single-arm phasei experimental trial. Under general anesthesia, total rectal prolapse was surgically reproduced in five pigs. Transanal endoscopic reduction of the rectal prolapse was performed. The best site for transillumination of the abdominal wall, suitable for rectopexy, was identified. The EndoLifter was used to approximate the anterior wall of the proximal rectum to the anterior abdominal wall. Two percutaneous rectopexies were performed by puncture with the Loop FixtureII Gastropexy Kit®at the preset site of transillumination. After the percutaneous rectopexies, rectoscopy and exploratory laparotomy were performed. Finally, the animals were euthanized.
  
  
  RESULTS
  The mean procedure time was 16min (11-21) and the mean length of the mobilized specimen was 4.32cm (range 2.9-5.65cm). A total of 10 fixations were performed with a technical success rate of 100%. There was no evidence of postoperative rectal prolapse in any of the animals. The EndoLifter facilitated the process by allowing the mucosa to be held and manipulated during the repair.
  
  
  CONCLUSIONS
  Endoscopic-assisted percutaneous rectopexy is a safe and feasible endoluminal procedure for fixation of the rectum to the anterior abdominal wall in experimental animals.
authors.affiliation: Coloproctología, Departamento de Gastroenterología, División Quirúrgica, Escuela de Medicina de la Universidad de Sao Paulo, Sao Paulo, Brasil. Electronic address: leonardoabustamante@gmail.com.
authors.forename: L
authors.initials: L
authors.lastname: Bustamante-Lopez
authors.affiliation: Servicio de Endoscopia Gastrointestinal, Departamento de Gastroenterología, División Quirúrgica, Escuela de Medicina de la Universidad de Sao Paulo, Sao Paulo, Brasil.
authors.forename: M
authors.initials: M
authors.lastname: Sulbaran
authors.affiliation: Servicio de Endoscopia Gastrointestinal, Departamento de Gastroenterología, División Quirúrgica, Escuela de Medicina de la Universidad de Sao Paulo, Sao Paulo, Brasil.
authors.forename: C
authors.initials: C
authors.lastname: Sakai
authors.affiliation: Servicio de Endoscopia Gastrointestinal, Departamento de Gastroenterología, División Quirúrgica, Escuela de Medicina de la Universidad de Sao Paulo, Sao Paulo, Brasil.
authors.forename: E G
authors.initials: EG
authors.lastname: de Moura
authors.affiliation: Unidad de Coloproctología, División Quirúrgica, Universidad de Zulia, Maracaibo, Zulia, Venezuela.
authors.forename: L
authors.initials: L
authors.lastname: Bustamante-Perez
authors.affiliation: Coloproctología, Departamento de Gastroenterología, División Quirúrgica, Escuela de Medicina de la Universidad de Sao Paulo, Sao Paulo, Brasil.
authors.forename: C S
authors.initials: CS
authors.lastname: Nahas
authors.affiliation: Coloproctología, Departamento de Gastroenterología, División Quirúrgica, Escuela de Medicina de la Universidad de Sao Paulo, Sao Paulo, Brasil.
authors.forename: S C
authors.initials: SC
authors.lastname: Nahas
authors.affiliation: Coloproctología, Departamento de Gastroenterología, División Quirúrgica, Escuela de Medicina de la Universidad de Sao Paulo, Sao Paulo, Brasil.
authors.forename: I
authors.initials: I
authors.lastname: Cecconello
authors.affiliation: Servicio de Endoscopia Gastrointestinal, Departamento de Gastroenterología, División Quirúrgica, Escuela de Medicina de la Universidad de Sao Paulo, Sao Paulo, Brasil.
authors.forename: P
authors.initials: P
authors.lastname: Sakai
mesh_terms: D000818:Animals; D016099:Endoscopy, Gastrointestinal / Q000295:instrumentation* / Q000379:methods*; D005240:Feasibility Studies; D007813:Laparotomy; D012005:Rectal Prolapse / Q000601:surgery*; D034421:Sus scrofa; D013552:Swine
keywords: EndoLifter; Endoscopia; Endoscopy; Prolapso rectal; Rectal prolapse; Rectopexia; Rectopexy