Mesh fistulation into the rectum after laparoscopic ventral mesh rectopexy

INTRODUCTION: Laparoscopic ventral mesh rectopexy (LVMR) is an effective method of management of functional disorders of the rectum including symptomatic rectal intussusception, and obstructed defaecation. Despite the technical demands of the procedure and common use of foreign body (mesh), the incidence of mesh related severe complications of the rectum is very low. PRESENTATION OF CASE: A 63 year old woman presented with recurrent pelvic sepsis following a mesh rectopexy. Investigations revealed fistulation of the mesh into the rectum. She was treated with an anterior resection. DISCUSSION: The intraoperative findings and management of the complication are described. Risk factors for mesh attrition and fistulation are also discussed. CONCLUSION: Chronic sepsis may lead to 'late' fistulation after mesh rectopexy. (C) 2013 The Authors. Published by Elsevier Ltd on behalf of Surgical Associates Ltd.