Annals of Coloproctology

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Original Articles

Benign proctology,Surgical technique

Transperineal rectocele repair is ideal for patients presenting with fecal incontinence: Marie Shella De Robles, Christopher J. Young; Ann Coloproctol. 2022;38(5):376-379. Published online October 19, 2021; DOI: https://doi.org/10.3393/ac.2021.00157.0022

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4 Web of Science
4 Citations

Purpose
Rectocele can be associated with both obstructed defecation and fecal incontinence. There exists a great variety of operative techniques to treat patients with rectocele. The purpose of this study was to evaluate the clinical outcome in a consecutive series of patients who underwent transperineal repair of rectocele when presenting with fecal incontinence as the predominant symptom.
Methods
Twenty-three consecutive patients from April 2000 to July 2015 with symptomatic rectocele underwent transperineal repair by a single surgeon.
Results
All patients had a history of vaginal delivery, with or without evidence of associated anal sphincter injury at the time. The median age of the cohort was 53 years (range, 21–90 years). None were fully continent preoperatively. However, continence improved to just rare mucus soiling or loss of flatus in all patients 6 months after their surgery. There was no operative mortality. Postoperative complications including urinary retention and wound dehiscence occurred in 3 patients.
Conclusion
Fecal incontinence associated with rectocele is multifactorial and may be caused by preexisting anal sphincteric damage and attenuation. Our experience suggests that transperineal repair provides excellent anatomic and physiologic results with minimal morbidity in selected patients presenting with combined rectocele and anal sphincter defect.

Citations

Citations to this article as recorded by

IUGA Opinion Paper on Obstructed Defecation: Management of Clinical and Proctographic Rectoceles
Suneetha Rachaneni, Hans Peter Dietz, Pallavi Latthe, Annie Sirany, Anna Spivak, Anupreet Dua
International Urogynecology Journal.2026; 37(1): 75. CrossRef
Beyond stapled transanal rectal resection vs ventral rectopexy dichotomy: Toward a phenotype-guided surgical paradigm for obstructed defecation syndrome
Michele Schiano di Visconte, Sonia Sarnari
World Journal of Gastrointestinal Surgery.2026;[Epub] CrossRef
Fecal Incontinence Outcomes Following Transvaginal Posterior Vaginal Wall Repair
Jersey B. Burns, Amr El Haraki, Jesseca Crawford, Candace Y. Parker-Autry
International Urogynecology Journal.2025; 36(5): 1061. CrossRef
The American Society of Colon and Rectal Surgeons Clinical Practice Guidelines for the Evaluation and Management of Chronic Constipation
Karim Alavi, Amy J. Thorsen, Sandy H. Fang, Pamela L. Burgess, Gino Trevisani, Amy L. Lightner, Daniel L. Feingold, Ian M. Paquette
Diseases of the Colon & Rectum.2024; 67(10): 1244. CrossRef

Hand-Assisted Laparoscopic Surgery: A Versatile Tool for Colorectal Surgeons: Ju Yong Cheong, Christopher J. Young; Ann Coloproctol. 2017;33(4):125-129. Published online August 31, 2017; DOI: https://doi.org/10.3393/ac.2017.33.4.125

6,966 View
67 Download
8 Web of Science
7 Citations

Abstract PDF

Purpose

Hand-assisted laparoscopic surgery (HALS) is a minimally invasive surgical technique with the combined benefits of laparoscopic surgery while allowing the use of the surgeon's hand for better tactile control. Obesity has been associated with higher conversion rates with multiport laparoscopic surgery, but not with HALS. This study aimed to examine the versatility of HALS in various clinical contexts.

Methods

All HALSs performed at 2 major tertiary centers in Sydney were prospectively collected for retrospective analysis. Variables including age, sex, body mass index (BMI), previous surgeries, pathologies including size and T-stage, and the number of conversions to a midline laparotomy were examined.

Results

A total of 121 HALS colorectal resections were analyzed. The median age of the patients was 62 years, with 63.6% being women. Seven patients required conversion to a midline laparotomy. Of the 121 patients, 50.2% were overweight or obese, and 52.9% had undergone previous abdominal/pelvic operations. However, neither obesity nor abdominal adhesions from previous operations were an indication for conversion to an open laparotomy in any of the 7 converted patients. The presence of intra-abdominal adhesions did not impact the operative time. HALS allowed access to the entire colon and rectum and allowed resection of the bladder, uterus, and ureter, when these organs were involved.

Conclusion

HALS is a versatile, minimally invasive technique, which is independent of the patient's BMI, for performing a colorectal resection.

Citations

Citations to this article as recorded by

Hand-assisted Laparoscopic Surgery (HALS) as an Alternative to Laparoscopic Converted to Open Surgery (LCOS) in Proctectomy Patients
Stephanie S. Hyon, Jana K. Elsawwah, Rahul Narang, Patricia B. Stopper, Rolando H. Rolandelli, Zoltan H. Nemeth
Surgical Laparoscopy, Endoscopy & Percutaneous Techniques.2026;[Epub] CrossRef
Hand-Assisted Laparoscopic Surgery (HALS) as an Alternative to Unplanned Laparoscopic Conversion to Open Surgery (LCOS) in Colectomies for Acute Diverticulitis
Satyam K. Ghodasara, Jana K. Elsawwah, Stephanie S. Hyon, Joseph S. Flanagan, Patricia B. Stopper, Rolando H. Rolandelli, Zoltan H. Nemeth
Surgical Innovation.2025; 32(3): 222. CrossRef
Comparative clinical efficacy of three surgical modalities for the treatment of malignant tumours of the left hemicolon
Hao Chen, Dong-Ping Han, Jian-Yang Xiong, Zhen-Sheng Li, Teng-Cheng Hu, Zheng-Rong Li, Yi Cao
World Journal of Gastrointestinal Surgery.2025;[Epub] CrossRef
Usefulness of Hand-assisted Laparoscopic Restorative Proctocolectomy for Ulcerative Colitis in the Era of Laparoscopic Surgery - A Single-center Observational Study
Hideaki Kimura, Kenichiro Toritani, Itaru Endo
Journal of the Anus, Rectum and Colon.2024; 8(3): 228. CrossRef
A single centre audit: repeat pre‐operative colonoscopy
Michelle Zhiyun Chen, Hareshdeva Devan Nair, Apoorva Saboo, Sharon Chih Lin Lee, Xinchen Gu, Sheik Mohammad Azhar Auckloo, Sandeep Tamang, Sally Jiasi Chen, Ryan William Lowe, Neil Strugnell
ANZ Journal of Surgery.2022; 92(10): 2571. CrossRef
Application of Laparoscopy in Comprehensive Staging Operation of Ovarian Cancer Based on Electronic Medical Blockchain Technology
Limei Zhang, Xinrui Li, Yao Ning, Yufei Cai, Zhihan Lv
Journal of Healthcare Engineering.2021; 2021: 1. CrossRef
Need for Reappraisal of Hand-Assisted Laparoscopic Surgery for Colorectal Diseases in the Era of Desiring Small Incisions
Chang-Nam Kim
Annals of Coloproctology.2017; 33(4): 119. CrossRef

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