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Video ViewAttendees 2

Session: Video Abstract Session

V4 - What Went Wrong? A Video Series of Recurrent Prolapse After Ventral Rectopexy With Biologic Graft

Sunday, June 2, 2024
1:52 PM – 1:56 PM ET, USA
Location: Room 314-317

    Video Abstract Presenter(s)

  • David J. Droullard, MD, MS

    Fellow
    Corewell Health/Michigan State University
    Corewell Health/Michigan State University
    Grand Rapids, MI, United States

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

    • Senior Author(s)

  • James Ogilvie, Jr., MD, MS

    Clinical Assistant Professor
    Michigan State University
    MIchigan State University
    Grand Rapids, Michigan, United States

    All relevant financial disclosures have been managed and will be listed below.
    Cook Surgical: Teaching (Ongoing)

Purpose/Background: The causes of recurrent rectal prolapse after ventral rectopexy are not well described. We aim to characterize the modes of failure of ventral rectopexy among patients who underwent reoperation for recurrence after previous ventral rectopexy with biologic graft.

Methods/Interventions: Qualitative operative video review of all cases of reoperative minimally invasive rectopexy performed by a single surgeon between 2015 and 2023 for recurrent rectal prolapse after prior ventral rectopexy.

Results/Outcomes: Operative video was available for nine cases of reoperative rectopexy. Evidence of well-incorporated graft was encountered in all but one case. Three graft failure modes were identified: distal slippage (1/9), graft laxity with (3/9) and without (2/9) slippage, and graft resorption (1/9). In two cases, there was no structural issue with the graft to explain the recurrent prolapse.

Conclusion/Discussion: Resorption of biologic graft was an uncommon cause of recurrent prolapse after ventral rectopexy. Instead, slippage of the rectum from its point of fixation anteriorly and laxity of the graft were more commonly identified at reoperation. Video review offers a novel method for investigating failure modes of minimally invasive operations.