A novel technique for correction of total rectal prolapse: Endoscopic-assisted percutaneous rectopexy with the aid of the EndoLifter
Introduction and aims: Rectal prolapse is common in the elderly, having an incidence of 1% in patients over 65 years 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 us...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2016-10-01
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| Series: | Revista de Gastroenterología de México (English Edition) |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2255534X16300536 |
| _version_ | 1818306725539741696 |
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| author | L. Bustamante-Lopez M. Sulbaran C. Sakai E.G. de Moura L. Bustamante-Perez C.S. Nahas S.C. Nahas I. Cecconello P. Sakai |
| author_facet | L. Bustamante-Lopez M. Sulbaran C. Sakai E.G. de Moura L. Bustamante-Perez C.S. Nahas S.C. Nahas I. Cecconello P. Sakai |
| author_sort | L. Bustamante-Lopez |
| collection | DOAJ |
| description | Introduction and aims: Rectal prolapse is common in the elderly, having an incidence of 1% in patients over 65 years 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.
Materials and methods: The study is a single-arm phase i 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 Fixture II 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 16 min (11-21) and the mean length of the mobilized specimen was 4.32 cm (range 2.9-5.65 cm). 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. |
| first_indexed | 2024-12-13T06:47:03Z |
| format | Article |
| id | doaj.art-fb5c8dec21ff401fa97746d34b1e2854 |
| institution | Directory Open Access Journal |
| issn | 2255-534X |
| language | English |
| last_indexed | 2024-12-13T06:47:03Z |
| publishDate | 2016-10-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Revista de Gastroenterología de México (English Edition) |
| spelling | doaj.art-fb5c8dec21ff401fa97746d34b1e28542022-12-21T23:56:15ZengElsevierRevista de Gastroenterología de México (English Edition)2255-534X2016-10-0181420220710.1016/j.rgmxen.2016.10.001A novel technique for correction of total rectal prolapse: Endoscopic-assisted percutaneous rectopexy with the aid of the EndoLifterL. Bustamante-Lopez0M. Sulbaran1C. Sakai2E.G. de Moura3L. Bustamante-Perez4C.S. Nahas5S.C. Nahas6I. Cecconello7P. Sakai8Coloproctología, Departamento de Gastroenterología, División Quirúrgica, Escuela de Medicina de la Universidad de Sao Paulo, Sao Paulo, BrazilServicio de Endoscopia Gastrointestinal, Departamento de Gastroenterología, División Quirúrgica, Escuela de Medicina de la Universidad de Sao Paulo, Sao Paulo, BrazilServicio de Endoscopia Gastrointestinal, Departamento de Gastroenterología, División Quirúrgica, Escuela de Medicina de la Universidad de Sao Paulo, Sao Paulo, BrazilServicio de Endoscopia Gastrointestinal, Departamento de Gastroenterología, División Quirúrgica, Escuela de Medicina de la Universidad de Sao Paulo, Sao Paulo, BrazilUnidad de Coloproctología, División Quirúrgica, Universidad de Zulia, Maracaibo, Zulia, VenezuelaColoproctología, Departamento de Gastroenterología, División Quirúrgica, Escuela de Medicina de la Universidad de Sao Paulo, Sao Paulo, BrazilColoproctología, Departamento de Gastroenterología, División Quirúrgica, Escuela de Medicina de la Universidad de Sao Paulo, Sao Paulo, BrazilColoproctología, Departamento de Gastroenterología, División Quirúrgica, Escuela de Medicina de la Universidad de Sao Paulo, Sao Paulo, BrazilServicio de Endoscopia Gastrointestinal, Departamento de Gastroenterología, División Quirúrgica, Escuela de Medicina de la Universidad de Sao Paulo, Sao Paulo, BrazilIntroduction and aims: Rectal prolapse is common in the elderly, having an incidence of 1% in patients over 65 years 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. Materials and methods: The study is a single-arm phase i 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 Fixture II 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 16 min (11-21) and the mean length of the mobilized specimen was 4.32 cm (range 2.9-5.65 cm). 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.http://www.sciencedirect.com/science/article/pii/S2255534X16300536RectopexyEndoscopyRectal prolapseEndoLifter |
| spellingShingle | L. Bustamante-Lopez M. Sulbaran C. Sakai E.G. de Moura L. Bustamante-Perez C.S. Nahas S.C. Nahas I. Cecconello P. Sakai A novel technique for correction of total rectal prolapse: Endoscopic-assisted percutaneous rectopexy with the aid of the EndoLifter Revista de Gastroenterología de México (English Edition) Rectopexy Endoscopy Rectal prolapse EndoLifter |
| title | A novel technique for correction of total rectal prolapse: Endoscopic-assisted percutaneous rectopexy with the aid of the EndoLifter |
| title_full | A novel technique for correction of total rectal prolapse: Endoscopic-assisted percutaneous rectopexy with the aid of the EndoLifter |
| title_fullStr | A novel technique for correction of total rectal prolapse: Endoscopic-assisted percutaneous rectopexy with the aid of the EndoLifter |
| title_full_unstemmed | A novel technique for correction of total rectal prolapse: Endoscopic-assisted percutaneous rectopexy with the aid of the EndoLifter |
| title_short | A novel technique for correction of total rectal prolapse: Endoscopic-assisted percutaneous rectopexy with the aid of the EndoLifter |
| title_sort | novel technique for correction of total rectal prolapse endoscopic assisted percutaneous rectopexy with the aid of the endolifter |
| topic | Rectopexy Endoscopy Rectal prolapse EndoLifter |
| url | http://www.sciencedirect.com/science/article/pii/S2255534X16300536 |
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