Closed loop small bowel obstruction post laparoscopic rectopexy

Discussion:

This patient underwent laparoscopic rectopexy. Rectopexy is also called proctopexy. This entails suturing the rectum to the sacrum with the use of a polypropylene mesh that attaches to the sides of the lifted rectum and is attached to the anterior longitudinal ligament at the sacral promontory with the use of surgical titanium tacks or alternatively nonabsorbable glue. The procedure is usually done as an open surgical procedure. Nowadays, due to improved laparoscopic expertise and experience, the procedure is done laparoscopically and also robotically with the use of the Da Vinci robotic system. This patient underwent a laparoscopic rectopexy and developed a severe subacute small bowel obstruction due to an internal hernia and consequent closed loop small bowel obstruction. Ischemic and gangrenous small bowel was found at the time of surgical intervention and bowel resection was performed. The patient had an otherwise unremarkable recovery post emergency surgery.

Disclosure: I, Ashesh I Ranchod, have no actual or potential ethical or financial conflict of interest in relation to this device. This case is not intended to be a personal endorsement or recommendation of this product.

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