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Published in:

01-11-2011

Endoscopic fixation of the rectum for rectal prolapse: a feasibility and survival experimental study

Authors: Jeffrey Milsom, Koiana Trencheva, Raghava Pavoor, Joseph DiRocco, Parul J. Shukla, Junichiro Kawamura, Toyooki Sonoda

Published in: Surgical Endoscopy | Issue 11/2011

Abstract

Background

In recent years, there has been considerable interest in developing technology as well as techniques that could widen the therapeutic horizons of endoscopy. Rectal prolapse, a benign localized condition causing considerable morbidity, could be an excellent focus for new endoscopic therapies. The aim of this study was to assess the feasibility and safety of endoluminal fixation of the rectum to the anterior abdominal wall, after pushing it up inside the body, using an in vivo animal model.

Methods

We performed an in vivo comparative surgical study in a porcine model, including laparoscopic mobilization of the rectum and posterior rectopexy (standard surgical method) or endoluminal tacking of the rectum. After proving feasibility in ex vivo and acute studies, we performed a survival study to evaluate the safety of endoluminal tacking of the mobilized rectum to the anterior abdominal wall. The main outcome measures were successful completion of the tasks, maintenance of the fixation, complications associated with the methods, and survival studies including histopathological examinations of the fixation sites.

Results

There were two groups: laparoscopic rectopexy (8 animals) and endoluminal fixation of the rectum to the anterior abdominal wall (10 animals). There were no differences between these two groups in their postoperative recovery. The group with the endoluminal fixation was found to have adequate attachment of the rectum to the anterior abdominal wall (measured attachment pressure in the endoluminal group = 6.06 ± 0.52 ft-lb, in the control group = 4.86 ± 2.00 ft-lb) on both gross and microscopic evaluation.

Conclusion

Endoscopic fixation of the mobilized rectum is feasible and safe in this model and in the future may provide an effective alternative to current treatment options for rectal prolapse.

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Title: Endoscopic fixation of the rectum for rectal prolapse: a feasibility and survival experimental study
Authors: Jeffrey Milsom
Koiana Trencheva
Raghava Pavoor
Joseph DiRocco
Parul J. Shukla
Junichiro Kawamura
Toyooki Sonoda
Publication date: 01-11-2011
Publisher: Springer-Verlag
Published in: Surgical Endoscopy / Issue 11/2011
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-011-1778-y

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Springer Medicine

Endoscopic fixation of the rectum for rectal prolapse: a feasibility and survival experimental study

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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