2021 Volume 17 Issue 1 Pages 19-23
An 86-year-old female without any histories of neither abdominal surgery nor peritonitis presented with rectal prolapse and pelvic organ prolapse. We planned to perform laparoscopic sacrocolpopexy with ventral rectopexy (LSC+LVR). The preoperative CT revealed medially displaced descending colon and no SD-junction at the supposed area, and the patient was considered as having persistent descending mesocolon. Intraoperative findings revealed dense matted adhesion of sigmoid colon with mesentery and right pelvic wall. L5S1 anterior longitudinal ligament was exposed and secured the anchoring suture after the dissection of these adhesions and consecutive plane oriented presacral dissection, and LSC+LVR was completed. The peritoneal closure was also completed although was complicated due to widely dissected area. Operative time was 190 min, blood loss was minimal, and no complication or recurrence was observed by 1 year after operation. Dense adhesion inside pelvis with PDM could be some difficulty during LSC procedure, herein we report the case.
