Wednesday, May 4, 7:00 am – 12:00 pm
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, enteroceles and internal rectal prolapse and can be combined with vaginal prolapse procedures, such as sacrocolpopexy, in patients with multicompartment pelvic floor defects. Anterior repair of rectal prolapse and intussusception provides direct support to the anatomy that is commonly found to be the lead point for posterior compartment prolapse.
VR is technically demanding and requires a complete ventral dissection of the rectovaginal septum (rectovesical in men) down to the pelvic floor. Positioning the mesh and suturing must be done within a confined space. Poor technique minimizes the functional benefit and increases the risk for complications or recurrent prolapse. Formal training programs in VR can help to avoid complications and improve outcomes.
During this workshop attendees will watch live surgeries as they occur.
Objectives
At the conclusion of this session, participants should be able to:
- Explain the technical steps involved in ventral rectopexy
- Discuss the surgical risks associated with ventral rectopexy and the use of mesh
- Recognize the indications for performing a ventral rectopexy repair
- Collaborate with multidisciplinary surgical teams to perform a comprehensive pelvic floor reconstruction
Agenda
Co-Directors: Joseph Carmichael, MD, Orange, CA and Sarah Vogler, MD, Cleveland, OH
Social Media Moderators
Joy Chen, MD, Seattle, WA
Introduction and Explanation of Agenda
Joseph Carmichael, MD, Orange, CA
Sarah Vogler, MD, Cleveland, OH
Finding the Right Patient for Robotic/Laparoscopic Ventral Rectopexy
Rowan Collinson, MBChB, FRACS, Auckland, New Zealand
VR for ODS and Internal Rectal Intussusception
Brooke Gurland, MD, Stanford, CA
Off to the OR – Ideal Setup, Steps of Surgery and our Patients for Today
Jenny Speranza, MD, Rochester, NY
Live Surgery Viewing & Panel Discussion –Review of Patients Having Surgery and Experience of Live Surgeons
Live Surgeon: Amy Thorsen, MD, Minneapolis MN
Tips and Tricks for Anterior Rectal Dissection
Sarah Vogler, MD, Cleveland, OH
Live Surgery Viewing & Panel Discussion –Laparoscopic versus Robotic Approach, Extent of Dissection
Live Surgeon: Amy Thorsen, MD, Minneapolis, MN
Multidisciplinary Repair of Pelvic Organ Prolapse During Ventral Rectopexy
Katie Propst, MD, Cleveland, OH
Live Surgery Viewing & Panel Discussion – Discuss Mesh Being Used and Nuances to Mesh Positioning and How Mesh is Anchored
Live Surgeon: Amy Thorsen, MD, Minneapolis, MN
Everything You Need to Know about VR and Mesh (type, shape, size, placement, problems)
Joseph Carmichael, MD, Irvine, CA
Live Surgery Viewing & Panel Discussion – Planning for Multidisciplinary Repair, Order of Steps with 2 Teams, Preop/Post-op Evaluations
Live Surgeon: Amy Thorsen, MD, Minneapolis, MN
Live Surgery Viewing & Panel Discussion – Nuances of Tensioning the Mesh and Outcomes if Mesh is Too Tight or Too Loose
Live Surgeon: Amy Thorsen, MD, Minneapolis, MN
VR Post-op Routine and Expected Outcomes
Liliana Bordeianou, MD, Boston, MA
Questions and Answers with Panel and Live Surgeons
Live Surgeon: Amy Thorsen, MD, Minneapolis, MN
12:00 - Adjourn