CME Credit Hours, Symposium: 4.5
Rectal prolapse is a relatively common debilitating condition with both functional and anatomic sequelae.
Ventral Rectopexy (VR) is the current gold standard for treatment of rectal prolapse in most countries outside of North America. VR can correct full-thickness rectal prolapse, rectoceles and internal rectal prolapse and can be combined with vaginal prolapse procedures, such as sacrocolpopexy, in patients with multicompartment pelvic floor defects. Limiting dissection to the anterior rectum minimizes autonomic nerve damage associated with posterior dissection and division of the lateral stalks.
VR is technically demanding and requires a complete ventral dissection of the rectovaginal septum (rectovesical in men) down to the pelvic floor and suturing skills within a confined space that further maximizes the difficulty. Poor technique minimizes the functional benefit and increases the risk for complications. Formal training programs in VR can help to avoid complications and improve outcomes.
Objectives
At the conclusion of this session, participants should be able to:
- Explain ventral rectopexy, indications and long-term outcomes
- Describe surgical steps for ventral rectopexy using a minimally invasive approach such as laparoscopy or robotics
- Distinguish how to avoid and how deal with surgical complication after prolapse surgery
- Refine VR technique and improve efficiency
Co-Directors
Brooke Gurland, MD, Stanford, CA
James Ogilvie, Jr., MD, Grand Rapids, MI
Andrew Stevenson, MD, Brisbane, Australia
Introduction
Brooke Gurland, MD, Stanford, CA
Principles and Evolution of Procedures for Rectal Prolapse
Anders Mellgren, MD, PhD, Chicago, IL
Testing? What Helps Me Prior to Prolapse/VR Repair?
Amy Thorsen, MD, Minneapolis, MN
Rectal Prolapse Outcomes: How Does Ventral Rectopexy Measure Up
Mehraneh Dorna Jafari, MD, Irvine, CA
RVR Getting Started: VR / Initial Patient Selection and Booking Your First Few Cases
Kenneth Loh, MD, San Francisco, CA
To Mesh or Not Mesh in Multicompartment Prolapse
Liliana Bordeianou, MD, Boston, MA
LX VR – How I Do It
James Ogilvie, Jr., MD, Grand Rapids, MI
Robotic VR - How I Do It
Joseph Carmichael, MD, Irvine, CA
VR for ODS and IRP
Sara Vogler, MD, Cleveland, OH
Management and Prevention of VR Complications
Elizabeth Raskin, MD, Loma Linda, CA
Recurrent Rectal Prolapse: Where Does VR Fit In?
Ian Paquette, MD, Cincinnati, OH
Pelvic Mesh and Sacrocolopexy Pearls Applicable to VR
Felicia Lane, MD, Irvine, CA
Cases and Panel Discussion
Brooke Gurland, MD, Stanford, CA
James Ogilvie, Jr., MD, Grand Rapids, MI
Andrew Stevenson, MD, Brisbane, Australia
Question and Answer
Adjourn