Safety of non-absorbable tack fixation in laparoscopic ventral rectopexy for external and high-grade internal rectal prolapse: early outcomes from a single-centre cohort.

Λεπτομέρειες βιβλιογραφικής εγγραφής
Τίτλος:	Safety of non-absorbable tack fixation in laparoscopic ventral rectopexy for external and high-grade internal rectal prolapse: early outcomes from a single-centre cohort.
Συγγραφείς:	Coppola A; Colorectal Surgery Unit, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132, Milan, Italy., Palmieri F; Colorectal Surgery Unit, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132, Milan, Italy., Missaglia C; Colorectal Surgery Unit, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132, Milan, Italy., Manfrino L; Colorectal Surgery Unit, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132, Milan, Italy., Gravante G; Department of General Surgery, Azienda Sanitaria Locale ASL Lecce, Casarano, Italy., Cozzolino ST; Vita-Salute San Raffaele University, 20132, Milan, Italy., Gallo G; Colorectal Surgery Unit, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132, Milan, Italy. gallo.gaetano@hsr.it.; Vita-Salute San Raffaele University, 20132, Milan, Italy. gallo.gaetano@hsr.it., Sileri P; Colorectal Surgery Unit, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132, Milan, Italy.; Vita-Salute San Raffaele University, 20132, Milan, Italy.
Πηγή:	Updates in surgery [Updates Surg] 2026 Sep; Vol. 78 (5), pp. 1999-2005. Date of Electronic Publication: 2026 Mar 16.
Τύπος έκδοσης:	Journal Article
Γλώσσα:	English
Στοιχεία περιοδικού:	Publisher: Springer-Verlag Italia Country of Publication: Italy NLM ID: 101539818 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2038-3312 (Electronic) Linking ISSN: 2038131X NLM ISO Abbreviation: Updates Surg Subsets: MEDLINE
Imprint Name(s):	Original Publication: Milano : Springer-Verlag Italia
Ιατρικοί όροι (MeSH):	Rectal Prolapse/surgery , Laparoscopy/methods , Rectum/surgery , Surgical Mesh, Postoperative Pain/epidemiology ; Postoperative Complications/epidemiology ; Humans ; Female ; Middle Aged ; Treatment Outcome ; Aged ; Colorectal Surgical Procedures ; Cohort Studies ; Time Factors ; Operative Time
Περίληψη:	The optimal method for mesh fixation during laparoscopic ventral rectopexy (LVR) remains debated, particularly regarding its impact on postoperative chronic pelvic pain and infectious complications. This study aimed to evaluate the safety and early outcomes of non-absorbable helical tack fixation in patients undergoing LVR for external rectal prolapse or high-grade internal prolapse Particular attention was paid to the identification and preservation of key neurovascular structures, including the right hypogastric nerve, L5-S1 intervertebral disc, and first sacral nerve. Mesh fixation over the sacral promontory was performed using three 5-mm non-absorbable helical tacks. Perioperative outcomes and postoperative pain recorded at 30 days, and 3 months were reported. Eighty-seven women underwent LVR between June 2023 and February 2025 (mean age 59.2 ± 12.8 years; BMI 23.5 ± 3.4 kg/m²), 38 with additional sacrocolpopexy (SC). Operative time was 116 min (range: 60-190). No intraoperative conversion occurred and one port-site bleeding was the only intraoperative complication observed. Hospital stay was 2 days (range 2-6); the early postoperative course was uneventful in all patients. At 30 days, 8 (9.2%) patients reported mild pain, and 5 (5.2%) moderate pain. At 3 months, 4 patients (4.6%) reported mild pain. No cases of chronic neuropathic pelvic pain, spondylodiscitis, or tack-related complications were observed. No differences were present among LVR and LVR plus SC for all parameters investigated. In this single-centre cohort, non-absorbable helical tack fixation during LVR was associated with favourable early postoperative outcomes and a low incidence of pain and complications when meticulous surgical technique was applied. However, in the absence of a comparator group, these findings should be interpreted as descriptive and limited to early postoperative safety. Prospective studies with long-term follow-up and a control group are warranted to confirm these findings and further optimize patient-centered outcomes. (© 2026. Italian Society of Surgery (SIC).)
Competing Interests:	Declarations. Conflict of interest: All authors declare no personal conflict of interest. Ethical approval: All procedures involving human participants were performed in accordance with the ethical standards of the institutional and/or national research committee and the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards. This article does not contain any studies using animals. Informed consent: Informed consent was obtained from the participants included in the study.
References:	Br J Surg. 2004 Nov;91(11):1500-5. (PMID: 15499644) Surg Endosc. 2012 Aug;26(8):2208-12. (PMID: 22302535) Am J Obstet Gynecol. 2017 Apr;216(4):388.e1-388.e7. (PMID: 27956200) Updates Surg. 2021 Oct;73(5):1819-1828. (PMID: 34138448) Clin Colon Rectal Surg. 2021 Jan;34(1):62-68. (PMID: 33536851) Surgery. 1992 May;111(5):518-26. (PMID: 1598671) Am J Obstet Gynecol. 2017 Nov;217(5):607.e1-607.e4. (PMID: 28709584) Tech Coloproctol. 2018 Dec;22(12):919-931. (PMID: 30554284) J Minim Access Surg. 2020 Jan-Mar;16(1):5-12. (PMID: 30416143) Dis Colon Rectum. 2025 May 1;68(5):593-607. (PMID: 39882786) Updates Surg. 2025 Dec;77(8):2417-2424. (PMID: 40601240) Surg Endosc. 2024 Dec;38(12):7073-7082. (PMID: 39516323) Surg Endosc. 2019 Aug;33(8):2444-2455. (PMID: 31041515) Female Pelvic Med Reconstr Surg. 2010 Jul;16(4):229-33. (PMID: 22453347) Tech Coloproctol. 2018 Apr;22(4):289-294. (PMID: 29594747) Tech Coloproctol. 2022 Aug;26(8):655-664. (PMID: 35593970) Dis Colon Rectum. 2022 May 1;65(5):615-616. (PMID: 34840305) Rheumatol Int. 1985;5(4):145-8. (PMID: 4048757) Tech Coloproctol. 2022 Dec;26(12):963-971. (PMID: 36104607) Eur J Obstet Gynecol Reprod Biol. 2024 Mar;294:170-179. (PMID: 38280271) Colorectal Dis. 2025 Apr;27(4):e70084. (PMID: 40195060) Tech Coloproctol. 2019 Feb;23(2):179-181. (PMID: 30788728) Curr Med Res Opin. 2006 Oct;22(10):1911-20. (PMID: 17022849) Colorectal Dis. 2021 Sep;23(9):2228-2285. (PMID: 34060715) Int J Colorectal Dis. 2025 Oct 16;40(1):214. (PMID: 41099852) Br J Surg. 2021 Oct 23;108(10):1149-1153. (PMID: 33864061) Arch Gynecol Obstet. 2022 Mar;305(3):631-639. (PMID: 34842976) Diabet Med. 2012 May;29(5):578-85. (PMID: 22023377) Eur J Obstet Gynecol Reprod Biol. 2010 Sep;152(1):103-7. (PMID: 20542624) Dis Colon Rectum. 2022 May 1;65(5):750-757. (PMID: 34840303) Dis Colon Rectum. 2019 Dec;62(12):1512-1517. (PMID: 31569096)
Contributed Indexing:	Keywords: Full thickness rectal prolapse; Internal prolapse; Laparoscopic ventral rectopexy; Neuropathic pain; Non-absorbable tack; Pelvic pain; Spondylodiscitis
Entry Date(s):	Date Created: 20260316 Date Completed: 20260902 Latest Revision: 20261008
Update Code:	20261008
DOI:	10.1007/s13304-026-02594-x
PMID:	41838345
Βάση Δεδομένων:	MEDLINE

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Περιγραφή
ISSN:	2038-3312
DOI:	10.1007/s13304-026-02594-x