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Session: ePoster: Pelvic Floor 1 (Sun8)

EP339 - Ovine and Polypropylene Hybrid Mesh is a Safe Option in Ventral Mesh Rectopexy

Sunday, May 11, 2025
9:05 AM – 9:10 AM PT
Location: Monitor 8. Sails Pavilion, Upper Level

    ePoster Presenter(s)

  • Jade Nguyen, MD

    Resident Physician
    Huntington Hospital
    Glendale, CA, United States

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

    • Senior Author(s)

  • JG

    Juliane Y. Golan, MD

    Attending
    Huntington Hospital
    Pasadena, California, United States

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

    • Author(s)

  • MM

    Makenna Marty, MD

    General Surgery Resident
    Huntington Hospital
    Pasadena, CA, United States

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

  • VY

    Vickie Yoon, BS

    Assistant Researcher
    Huntington Hospital
    Pasadena, California, United States

    Disclosure information not submitted.

  • DN

    Dena Nasir, MD

    Fellow
    Huntington Hospital
    Pasadena, California, United States

    Disclosure information not submitted.

  • AT

    Adam Truong, MD, MS

    Attending
    Huntington Hospital
    pasadena, California, United States

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

  • HK

    Howard S. Kaufman, MD

    Attending
    Huntington Hospital
    Pasadena, California, United States

    Disclosure information not submitted.

  • GA

    Gabriel Akopian, MD, MBS

    General Surgery Residency Program Director
    Huntington Hospital
    Pasadena, California, United States

    Disclosure information not submitted.

  • LH

    Lucy F. Harvey, BA

    Medical Student
    Keck School of Medicine of USC
    Los Angeles, California, United States

    Disclosure information not submitted.

All of the relevant financial relationships listed below have been mitigated.
Jade Nguyen, MD: This individual has no financial relationships with ineligible companies.
Juliane Y. Golan, MD: This individual has no financial relationships with ineligible companies.
Makenna Marty, MD: This individual has no financial relationships with ineligible companies.
Adam Truong, MD, MS: This individual has no financial relationships with ineligible companies.
Image or Table (Do Not add text here):

Purpose/Background: Robotic ventral mesh rectopexy (VMR) is an established surgical procedure for rectal prolapse. The optimal choice of mesh remains debatable. Polypropylene (PP) mesh is the most commonly used synthetic option and is associated with low recurrence rates and good functional results. However, the potential for severe complications such as fistulization, erosion, and dyspareunia has driven considerations for biological mesh use. Most case series and systematic reviews comparing outcomes between laparoscopic VMR utilizing synthetic versus biological mesh have shown similar short term clinical outcomes. Composite meshes may represent another alternative that offers the safety of a biologic with the longer-term durability of a synthetic product. OviTex, a PP reinforced ovine extracellular matrix (hereafter reinforced tissue matrix, RTM) has been studied and used extensively for ventral hernia repair. Currently, there is limited data assessing the efficacy of RTM in robotic VMR. This study aims to evaluate the safety and short-term mesh-related complication rate of RTM in the treatment of rectal prolapse.

Methods/Interventions: We conducted a single-institution retrospective cohort study of 42 consecutive patients who underwent robotic VMR for rectal prolapse with RTM between January 2015 and March 2024. Patients who underwent VMR combined with sacral colpopexy for multicompartmental pelvic organ prolapse were excluded. Ninety-day post-operative complications were defined as either return to the operating room (OR) or nonoperative hospital readmission, with further analysis focused on indications for reoperation.

Results/Outcomes: The average age of this cohort was 70.3 years, and 93% were female. The mean OR time was 148 minutes and the average postoperative LOS was 1.6 days. The 90-day total complication rate was 14% with one nonoperative readmission (pneumonia). Five patients required reoperations including one unrelated inguinal hernia repair and two symptomatic port site hernias requiring repair. Two patients (5%) experienced mesh-related complications: one with an immediate recurrence of rectal prolapse necessitating a reinforced suture rectopexy and the other who developed a pelvic abscess one month post-operatively and ultimately required mesh explantation.

Conclusion/Discussion: To our knowledge, this is the first series of robotic VMR performed using reinforced tissue matrix. Our findings indicate that RTM is a safe alternative for robotic VMR for the treatment of rectal prolapse. The low rate of short-term mesh-related complications is comparable to the rates reported for other mesh choices. Studies assessing long-term functional results and repair durability for this cohort are ongoing.