Academic Journal
Laparoscopic-total extraperitoneal anterior rectopexy (L-TEAR)-a preliminary report.
| Title: | Laparoscopic-total extraperitoneal anterior rectopexy (L-TEAR)-a preliminary report. |
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| Authors: | Chandra A; Department of Surgical Gastroenterology, King George's Medical University, Lucknow, Uttar Pradesh, 226003, India. abhijitchandra@hotmail.com., Ganesan D; Department of Surgical Gastroenterology, King George's Medical University, Lucknow, Uttar Pradesh, 226003, India., Rajashekhara M; Department of Surgical Gastroenterology, King George's Medical University, Lucknow, Uttar Pradesh, 226003, India., Manoharan A; Department of Surgical Gastroenterology, King George's Medical University, Lucknow, Uttar Pradesh, 226003, India., Agrawal A; Department of Surgical Gastroenterology, King George's Medical University, Lucknow, Uttar Pradesh, 226003, India., Rajan P; Department of Surgical Gastroenterology, Aster Medcity, Kochi, Kerala, 682027, India., Jain R; Department of Surgical Gastroenterology, King George's Medical University, Lucknow, Uttar Pradesh, 226003, India., Shah J; Department of Surgical Gastroenterology, King George's Medical University, Lucknow, Uttar Pradesh, 226003, India. |
| Source: | Techniques in coloproctology [Tech Coloproctol] 2026 Mar 02; Vol. 30 (1). Date of Electronic Publication: 2026 Mar 02. |
| Publication Type: | Journal Article; Evaluation Study |
| Language: | English |
| Journal Info: | Publisher: Springer-Verlag Italia Country of Publication: Italy NLM ID: 9613614 Publication Model: Electronic Cited Medium: Internet ISSN: 1128-045X (Electronic) Linking ISSN: 11236337 NLM ISO Abbreviation: Tech Coloproctol Subsets: MEDLINE |
| Imprint Name(s): | Publication: <2001->: Milano, Italy : Springer-Verlag Italia Original Publication: Rome : UCP Club |
| MeSH Terms: | Rectal Prolapse*/surgery , Rectal Prolapse*/complications , Laparoscopy*/methods , Rectum*/surgery, Postoperative Complications/etiology ; Fecal Incontinence/surgery ; Fecal Incontinence/etiology ; Humans ; Female ; Adult ; Prospective Studies ; Male ; Middle Aged ; Treatment Outcome ; Quality of Life ; Feasibility Studies ; Surgical Mesh ; Operative Time ; Young Adult ; Colorectal Surgical Procedures ; Length of Stay |
| Abstract: | Background: Complete rectal prolapse, associated incontinence and obstructive symptoms, significantly impairs quality of life. Minimally invasive ventral mesh rectopexy, the current standard, being transperitoneal, entails risks of vascular, bowel injury, and adhesions, besides mesh and tack fixation issues. This study evaluates the feasibility, safety, and short-term outcomes of a novel total extraperitoneal anterior rectopexy that avoids peritoneal transgression and sacral fixation. Methods: In this prospective single-center study conducted from July 2024 through the time of publishing, 20 patients (11 male, 9 female; mean age 34.6 ± 14.2 years) with complete rectal prolapse who had a body mass index < 28 kg/m2 and who had not had prior abdominal surgery underwent this procedure, which involved transfascial rectal fixation to the abdominal wall with preperitoneal mesh placement. Operative variables, complications, recurrence, functional outcomes [St. Mark's Incontinence Score (SMIS), obstructed defecation syndrome (ODS) score, quality-of-life questionnaires], sigmoidoscopy, manometry, and defecography were assessed. Results: Mean operative time was 181.2 ± 41.6 min, blood loss 70.6 ± 30.6 mL, and hospital stay 4.1 ± 2.7 days. During median 8-month follow-up, two patients (10%) experienced mucosal prolapse. There was no mortality nor were there major complications. Four patients developed transient hematuria, resolving conservatively. Significant improvements were observed in SMIS (18.6 ± 2.4 to 14.4 ± 2.8; p = 0.0357) and ODS scores (16.3 ± 3.2 to 8.1 ± 3.9; p < 0.0001). Quality-of-life improved, while manometric and defecographic parameters were not significantly altered. Conclusions: Total extraperitoneal anterior rectopexy is feasible and safe, avoiding peritoneal entry and sacral fixation while achieving favorable early outcomes. Larger, long-term validation is needed. (© 2026. The Author(s).) |
| Competing Interests: | Declarations. Conflict of interest: The authors declare no competing interests. Previous presentation and submission: This study was not previously submitted nor presented anywhere. Video abstract statement: We agree to provide the video abstract after provisional acceptance of the manuscript. |
| Comments: | Erratum in: Tech Coloproctol. 2026 May 13;30(1):63. doi: 10.1007/s10151-026-03331-7.. (PMID: 42126477) |
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| Contributed Indexing: | Keywords: Anterior rectopexy; Extraperitoneal; Minimally invasive; Rectal prolapse |
| Entry Date(s): | Date Created: 20260302 Date Completed: 20260709 Latest Revision: 20260920 |
| Update Code: | 20260920 |
| PubMed Central ID: | PMC12953484 |
| DOI: | 10.1007/s10151-025-03281-6 |
| PMID: | 41770256 |
| Database: | MEDLINE |
| ISSN: | 1128-045X |
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| DOI: | 10.1007/s10151-025-03281-6 |