{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,16]],"date-time":"2025-10-16T07:03:33Z","timestamp":1760598213256,"version":"build-2065373602"},"reference-count":28,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2022,12,30]],"date-time":"2022-12-30T00:00:00Z","timestamp":1672358400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Avoiding the extensive damage of pelvic structures during ventral rectopexy could minimize secondary disfunctions. The objective of our observational study is to assess the safety and functional efficacy of a modified ventral rectopexy. In the modified ventral rectopexy, a retroperitoneal tunnel was created along the right side of rectum, connecting two peritoneal mini-incisions at the Douglas pouch and sacral promontory. The proximal edge of a polypropylene mesh, sutured over the ventral rectum, was pulled up through the retroperitoneal tunnel and fixed to the sacral promontory. In all patients, radiopaque clips were placed on the mesh, making it radiographically \u201cvisible\u201d. Before surgery and at follow up visits, Altomare, Longo, CCSS, PAC-SYM, and CCFI scores were collected. From March 2010 to September 2021, 117 patients underwent VR. Modified ventral rectopexy was performed in 65 patients, while the standard ventral rectopexy was performed in 52 patients. The open approach was used in 97 cases (55 and 42 patients in modified and standard VR, respectively), while MI surgery was used in 20 cases (10 and 10 patients in modified and standard VR, respectively). A slightly shorter operative time and hospital stay were observed following modified ventral rectopexy (though this was not statistically significant). Similar overall complication rates were registered in the modified vs. standard ventral rectopexies (4.6% vs. 5.8%, p = 0.779). At follow-up, the Longo score (14.0 \u00b1 8.6 vs. 11.0 \u00b1 8.2, p = 0.042) and \u201cdelta\u201d values of Altomare (9.2 \u00b1 6.1 vs. 5.9 \u00b1 6.3, p = 0.008) and CCSS (8.4 \u00b1 6.3 vs. 6.1 \u00b1 6.1, p = 0.037) scores were significantly improved in the modified ventral rectopexy group. A similar occurrence of symptoms recurrence was diagnosed in the two groups. Radiopaque clips helped to accurately diagnose mesh detachment\/dislocation. The proposed modified VR seems to be feasible and safe. Marking the mesh intraoperatively seems useful.<\/jats:p>","DOI":"10.3390\/jcm12010294","type":"journal-article","created":{"date-parts":[[2022,12,30]],"date-time":"2022-12-30T03:18:18Z","timestamp":1672370298000},"page":"294","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Tunneling of Mesh during Ventral Rectopexy: Technical Aspects and Long-Term Functional Results"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2172-3334","authenticated-orcid":false,"given":"Paola","family":"Campenn\u00ec","sequence":"first","affiliation":[{"name":"Proctology Unit, Fondazione Policlinico Universitario \u201cAgostino Gemelli\u201d IRCCS, 00168 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8384-5081","authenticated-orcid":false,"given":"Angelo Alessandro","family":"Marra","sequence":"additional","affiliation":[{"name":"Proctology Unit, Fondazione Policlinico Universitario \u201cAgostino Gemelli\u201d IRCCS, 00168 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8628-2640","authenticated-orcid":false,"given":"Veronica","family":"De Simone","sequence":"additional","affiliation":[{"name":"Proctology Unit, Fondazione Policlinico Universitario \u201cAgostino Gemelli\u201d IRCCS, 00168 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesco","family":"Litta","sequence":"additional","affiliation":[{"name":"Proctology Unit, Fondazione Policlinico Universitario \u201cAgostino Gemelli\u201d IRCCS, 00168 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Angelo","family":"Parello","sequence":"additional","affiliation":[{"name":"Proctology Unit, Fondazione Policlinico Universitario \u201cAgostino Gemelli\u201d IRCCS, 00168 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0556-0037","authenticated-orcid":false,"given":"Carlo","family":"Ratto","sequence":"additional","affiliation":[{"name":"Proctology Unit, Fondazione Policlinico Universitario \u201cAgostino Gemelli\u201d IRCCS, 00168 Rome, Italy"},{"name":"Department of Medicine and Translational Surgery, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,12,30]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1500","DOI":"10.1002\/bjs.4779","article-title":"Long-term outcome of laparoscopic ventral rectopexy for total rectal prolapse","volume":"91","author":"Cadoni","year":"2004","journal-title":"Br. J. Surg."},{"key":"ref_2","first-page":"561","article-title":"Laparoscopic ventral rectopexy for external rectal prolapse is safe and effective in the elderly. Does this make perineal procedures obsolete?","volume":"13","author":"Wijffels","year":"2011","journal-title":"Color. Dis. Off. J. Assoc. Coloproctol. Great Br. Irel."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"O34","DOI":"10.1111\/codi.12751","article-title":"Ventral colporectopexy for overt rectal prolapse and obstructed defaecation syndrome: A systematic review","volume":"17","author":"Gouvas","year":"2015","journal-title":"Color. Dis."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1429","DOI":"10.1111\/codi.13893","article-title":"Position statement by the Pelvic Floor Society on behalf of the Association of Coloproctology of Great Britain and Ireland on the use of mesh in ventral mesh rectopexy","volume":"22","author":"Brown","year":"2020","journal-title":"Color. Dis."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"659","DOI":"10.1016\/S0399-8320(06)73257-2","article-title":"Technical and functional results after laparoscopic rectopexy to the promontory for complete rectal prolapse. Prospective study in 54 consecutive patients","volume":"30","author":"Auguste","year":"2006","journal-title":"Gastroenterol. Clin. Biol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"591","DOI":"10.1007\/s10151-013-1094-8","article-title":"Modified laparoscopic ventral mesh rectopexy","volume":"18","author":"Sileri","year":"2014","journal-title":"Techol. Coloproctol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1007\/s10151-013-1042-7","article-title":"Robotic-assisted and laparoscopic ventral rectopexy in the treatment of rectal prolapse: A matched-pairs study of operative details and complications","volume":"18","author":"Rautio","year":"2014","journal-title":"Techol. Coloproctol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"e469","DOI":"10.1111\/codi.12251","article-title":"Is robotic-assisted ventral mesh rectopexy superior to laparoscopic ventral mesh rectopexy in the management of obstructed defaecation?","volume":"15","author":"Mantoo","year":"2013","journal-title":"Color. Dis."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1495","DOI":"10.1016\/j.ijsu.2014.07.013","article-title":"STROBE Initiative The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement: Guidelines for reporting observational studies","volume":"12","author":"Altman","year":"2014","journal-title":"Int. J. Surg."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1111\/j.1463-1318.2007.01262.x","article-title":"Set-up and statistical validation of a new scoring system for obstructed defaecation syndrome","volume":"10","author":"Altomare","year":"2008","journal-title":"Color. Dis."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1205","DOI":"10.1007\/DCR.0b013e3181a9120f","article-title":"Stapled transanal rectal resection for obstructed defecation syndrome: One-year results of the European STARR Registry","volume":"52","author":"Jayne","year":"2009","journal-title":"Dis. Colon Rectum"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"681","DOI":"10.1007\/BF02056950","article-title":"A constipation scoring system to simplify evaluation and management of constipated patients","volume":"39","author":"Agachan","year":"1996","journal-title":"Dis. Colon Rectum"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"870","DOI":"10.1080\/003655299750025327","article-title":"Psychometric validation of a constipation symptom assessment questionnaire","volume":"34","author":"Frank","year":"1999","journal-title":"Scand. J. Gastroenterol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1007\/BF02050307","article-title":"Etiology and management of fecal incontinence","volume":"36","author":"Jorge","year":"1993","journal-title":"Dis. Colon Rectum"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"822","DOI":"10.1111\/j.1463-1318.2009.01891.x","article-title":"What is the natural history of internal rectal prolapse?","volume":"12","author":"Wijffels","year":"2010","journal-title":"Color. Dis."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"142","DOI":"10.1111\/codi.15929","article-title":"Modified robotic ventral mesh rectopexy\u2014A video vignette","volume":"24","author":"Ratto","year":"2022","journal-title":"Color. Dis."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1097\/01.sla.0000133083.54934.ae","article-title":"Classification of surgical complications: A new proposal with evaluation in a cohort of 6336 patients and results of a survey","volume":"240","author":"Dindo","year":"2004","journal-title":"Ann. Surg."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1149","DOI":"10.1093\/bjs\/znab123","article-title":"Obstructed defaecation syndrome: European consensus guidelines on the surgical management","volume":"108","author":"Picciariello","year":"2021","journal-title":"Br. J. Surg."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1121","DOI":"10.1097\/DCR.0000000000000889","article-title":"Clinical Practice Guidelines for the Treatment of Rectal Prolapse","volume":"60","author":"Bordeianou","year":"2017","journal-title":"Dis. Colon Rectum"},{"key":"ref_20","first-page":"CD001758","article-title":"Surgery for complete rectal prolapse in adults","volume":"2","author":"Bachoo","year":"2000","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1007\/s10151-022-02584-2","article-title":"The biomechanics of uterine prolapse impact rectal intussusception, ODS and surgical restoration","volume":"26","author":"Petros","year":"2022","journal-title":"Techol. Coloproctol."},{"key":"ref_22","first-page":"1193","article-title":"Biomechanical and morphological peculiarities of the rectum in patients with obstructed defecation syndrome","volume":"58","author":"Brunenieks","year":"2017","journal-title":"Rom. J. Morphol. Embryol. Rev. Roum. Morphol. Embryol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1016\/j.ijsu.2016.06.039","article-title":"A transanal procedure using TST STARR Plus for the treatment of Obstructed Defecation Syndrome: \u2018A mid-term study\u2019","volume":"32","author":"Ren","year":"2016","journal-title":"Int. J. Surg."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Siri, S., Zhao, Y., Maier, F., Pierce, D.M., and Feng, B. (2020). The Macro-and Micro-Mechanics of the Colon and Rectum I: Experimental Evidence. Bioengineering, 7.","DOI":"10.3390\/bioengineering7040130"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1016\/j.eclinm.2019.08.014","article-title":"Functional Outcome after Laparoscopic Posterior Sutured Rectopexy Versus Ventral Mesh Rectopexy for Rectal Prolapse: Six-year Follow-up of a Double-blind, Randomized Single-center Study","volume":"16","author":"Hidaka","year":"2019","journal-title":"EClinicalMedicine"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"4977","DOI":"10.3748\/wjg.v22.i21.4977","article-title":"Current status of laparoscopic and robotic ventral mesh rectopexy for external and internal rectal prolapse","volume":"22","author":"Paulides","year":"2016","journal-title":"World J. Gastroenterol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"O13","DOI":"10.1111\/codi.13574","article-title":"Abdominal rectopexy for the treatment of internal rectal prolapse: A systematic review and meta-analysis","volume":"19","author":"Emile","year":"2017","journal-title":"Color. Dis."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"2444","DOI":"10.1007\/s00464-019-06803-0","article-title":"Outcome of laparoscopic ventral mesh rectopexy for full-thickness external rectal prolapse: A systematic review, meta-analysis, and meta-regression analysis of the predictors for recurrence","volume":"33","author":"Emile","year":"2019","journal-title":"Surg. Endosc."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/1\/294\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:56:15Z","timestamp":1760147775000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/1\/294"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,12,30]]},"references-count":28,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2023,1]]}},"alternative-id":["jcm12010294"],"URL":"https:\/\/doi.org\/10.3390\/jcm12010294","relation":{},"ISSN":["2077-0383"],"issn-type":[{"type":"electronic","value":"2077-0383"}],"subject":[],"published":{"date-parts":[[2022,12,30]]}}}