Laparoscopic ventral mesh rectopexy – time to review?

Laparoscopic ventral mesh rectopexy has been gaining media coverage for several months now, especially since Jeremy Hunt announced the review into the vaginal mesh scandal, the pregnancy test, Primodos and the epilepsy drug, Sodium Valproate in February.

Mesh support groups were quick to raise the issue that the same mesh used in pelvic organ prolapse repair is used in the laparoscopic ventral mesh rectopexy procedure. They would like to know why this procedure is not also being reviewed.

Let’s take a Closer Look at the Laparoscopic Ventral Mesh Rectopexy Procedure

In order to understand these legalities, we must first define what this procedure involves. A Laparoscopic ventral mesh rectopexy is a procedure used to treat intussception, symptomatic rectocele and external rectal prolapse by straightening and fixing the rectum back into its normal anatomical position. A quick internet search reveals that this procedure is deemed a minimally invasive operation, offering a short hospital stay and less pain than traditional open surgery.

There are clearly advantages to the procedure and many women are reported to have found it very beneficial. However, a growing number of women are reporting complications which include:

• Chronic pelvic pain
• Nerve damage
• Severe constipation requiring pessaries or irrigation
• Incontinence
• Mesh erosion and the need for a redo operation.

These women are saying that prior to having the operation:-

• No alternative procedures were offered
• The procedure was explained to them as having very few risks
• There was often no mention that severe constipation could be a risk
• No mention that mesh was being used
• No mention that the mesh could erode and that it was permanent.

Additionally, when seeking further treatment for these complications, some of these women have discovered that additional procedures were performed without their explicit consent. Such procedures include a sacrocolpopexy and/or colporrhaphy. There was no discussion on the risks and benefits of these individual procedures during the consent process. This is especially important since the sacrocolpopexy procedure is currently subject to close scrutiny, and there is clear guidance that it should not be performed if there are no symptoms.

Enable Law Has Led Many Vaginal Mesh Cases Recently

In November 2017 a colorectal surgeon who was renowned for performing the laparoscopic ventral mesh rectopexy was placed under investigation by his local health trust and suspended from work. A significant number of that surgeon’s patients have needed considerable further corrective surgery. There is also concern that gynaecological or urogynaecological procedures have been carried out by a colorectal surgeon rather than by a gynaecological or urogynaecological surgeon or as part of a multi-disciplinary team.

Enable Law is representing a growing number of women who have suffered injury as a result of difficulties surrounding their laparoscopic ventral mesh rectopexy.

A Brief Look at the Sacrocolpopexy and the Colporrhaphy

What is Sacrocolpopexy?

This is a procedure to repair the pelvic organs by using mesh to attach the top of the vagina to the base of the spine, to support the pelvic organs.

NICE Guidance published in June 2017 states that given the specialist nature of this procedure, it should only be performed by clinicians specialising in the management of pelvic organ prolapse and urinary incontinence and who have specific up-to-date training and do the procedure regularly.

If such a procedure is to be performed alongside the laparoscopic ventral mesh rectopexy, then during the consent process, patients are likely to meet with two surgeons who are specialist at performing both procedures.

What is Colporrhaphy?

Colporrhapy Is a procedure whereby there is a repair of the front or back walls of the vagina. It is not usually performed for prolapse unless it is interfering with daily life.

Speak to Enable Law to Start your Mesh Negligence Claim

If you have been harmed by a laparoscopic ventral mesh procedure and/or have discovered additional procedures were performed, please get in touch with our team of medical negligence solicitors as you may have a gynaecology negligence claim. Request a call back today to get discreet, sympathetic and expert advice.

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