Advanced Methods for the Management of Rectal Prolapse Symposium and Workshop

Advanced Methods for the Management of Rectal Prolapse Symposium and Workshop | ASCRS

Saturday, June 1, 7:30 am – 4:30 pm
Up to 8 CME Credit Hours Total
Registration Required

Member Fee: $670
Non-Member Fee: $800
Limit: 20 participants
Lunch included

Didactic Session Only: $25 (7:30 am – Noon)
4.5 CME Credit Hours for Didactic Session only

Rectal prolapse is a relatively common debilitating condition with both functional and anatomic sequelae.

Throughout the past century, more than 100 different surgical procedures have been described and there is no consensus regarding the best technique1. Recurrence rates for complete rectal prolapse have been reported as high as 20-50 percent. The ideal surgical approach to treat these recurrences remains an unresolved problem.

Ventral rectopexy (VR) is the current gold standard for treatment of rectal prolapse in most countries outside of North America. Modern, minimally-invasive approaches to VR includes laparoscopic Ventral Rectopexy (LVR). VR can correct fullthickness 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.

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. Formal training programs in VR can help to avoid complications and improve outcomes.

Gap Analysis

What Is: Laparoscopic/ Robotic Ventral Rectopexy corrects descent of the anterior and middle pelvic floor compartments and has shown to be successful for improving full thickness rectal prolapse, internal prolapse, enterocele, rectocele, fecal incontinence, and obstructed defecation VR is considered the gold standard for rectal prolapse repair in Europe and Australia. There are few training opportunities in the USA for LVR or RVR.

What Should Be: Surgeons should have the opportunity to learn the techniques of LVR and RVR through didactic video-based learning and simulation. Surgeons should also be familiar other prolapse operations for patients who are not optimal candidates for VR.

Objectives

At the conclusion of this session, participants should be able to:

  1. Explain ventral rectopexy, indications and long-term outcomes.
  2. Describe surgical steps for Ventral Rectopexy using a minimally-invasive approach such as laparoscopy or robotics.
  3. Distinguish how to avoid and how deal with surgical complication after prolapse surgery.

Co-Directors

Brooke Gurland, MD, Stanford, CA
Andrew Stevenson, MD, Brisbane, Australia