Laparoscopic Protack™ rectopexy: Early experience of a novel technique for full thickness rectal prolapse in children

Abstract Background/purpose To review our early experience of laparoscopic ProTack™ rectopexy (LPR) in the management of full thickness rectal prolapse (FTRP) in children. Methods Prospective case series of patients undergoing LPR between 2013 and 2017. Full laparoscopic mobilization of the rectum was performed from the sacral promontory to the pelvic floor. 'Wings' of the lateral mesorectal peritoneum left attached to the rectum are then fixed to the sacral promontory using ProTack™. Demographics, associated conditions, previous procedures for FTRP, follow up time, length of stay (LOS), short and long term complications and clinical improvement were assessed. Results Seven consecutive patients with FTRP underwent LPR. The mean age was 9 years old (2–17) with a male to female ratio of 6:1. Median LOS was 1 day (1–2 days). Median follow up time was 17 months (10–38 months). All patients had complete resolution of symptoms within the follow up period. Conclusions LPR is a simple, safe and effective procedure showing promising results in children. It negates the risks associated with the use of mesh and has the potential to avoid the higher risk of failure associated with suture rectopexy. It is important to ensure patients receive adequate analgesia and management of postoperative constipation.