Ventral Rectopexy: An International Expert Panel Consensus and Review of Contemporary Literature.

Abstract

Background: Ventral rectopexy has become increasingly utilized in the surgical management of rectal prolapse. There is a need for a contemporary evaluation of the role of the procedure and description of its use in clinical practice.

Objective: To create an international consensus on ventral rectopexy.

Design: An expert panel undertook a scoping review of the literature to identify subject domains of interest. Literature reviews were completed for each domain with subsequent development of evidence-based and practice-based statements. These were compiled and reviewed by the group over a total of nine meetings. Once statements were confirmed, supportive text was finalized, and an anonymous vote was completed using REDCap to record consensus.

Setting: An international expert panel comprising colorectal surgeons who perform ventral rectopexy in a high-volume center.

Main outcome measures: Statements and associated expert consensus.

Results: Eleven experts identified ten domains for review: indications, contraindications, assessment and planning, consent, operative details, prostheses, complications, follow-up, recurrence and reoperative surgery and specific considerations. After round-table review, there were 17 resultant statements for consideration. Experts agreed unanimously with the thirteen of the statements and their accompanying text, with different experts disagreeing each with four statements (91% consensus each).

Limitations: Paucity of high-quality data.

Conclusion: This international group developed 17 statements with high consensus. These statements provide an up-to-date summary of the literature, identify key areas for research development and a reference point for colon and rectal surgeons who undertake ventral rectopexy as part of their practice. See Video Abstract.