Perineal Rectopexy via Suturing Console and Mesh
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Solution Overview
Problem
Current surgical methods for rectal prolapse, such as abdominal and perineal approaches, face issues with high recurrence rates, morbidity, and complications like constipation and incontinence, with existing perineal methods being less effective for larger prolapses and abdominal methods having higher morbidity and scarring.
Innovation Solution
A method and instrumentation that allows for attaching the posterior fascia of the rectum to the sacrum and coccyx via a posterior vaginal or perineal incision without abdominal incisions, using a specially designed suturing console with a spring-like needle to secure sutures between the rectal and sacral fascia, reducing the need for abdominal scarring and potentially lowering recurrence rates.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If abdominal surgical approach is used for rectal prolapse treatment, then recurrence rate is reduced, but morbidity and scarring increase
Solution Approach 1:
The patent inverts the traditional surgical approach by performing rectopexy through a perineal route rather than an abdominal route. This reversal allows the surgeon to access the rectum from below, avoiding abdominal incisions and their associated morbidity while still achieving effective fixation of the rectum to the sacrum, thus maintaining low recurrence rates without the harmful effects of abdominal surgery.
Solution Approach 2:
The patent introduces a mesh prosthesis as an intermediary material to facilitate rectal fixation. The mesh serves as a mediator between the rectum and sacrum, providing a stable anchoring surface that reduces recurrence while being inserted through the less invasive perineal approach, thereby decoupling the need for strong fixation from the need for large abdominal incisions.
2Object-affected harmful factors
If perineal surgical approach is used for rectal prolapse treatment, then morbidity is reduced, but recurrence rate increases
Solution Approach 1:
The mesh prosthesis acts as an intermediary that enhances the effectiveness of the perineal approach. By providing a robust fixation interface between the rectum and sacrum, the mesh compensates for the limitations of the perineal route, enabling reliable long-term fixation without requiring larger or more complex perineal incisions, thus maintaining low morbidity while reducing recurrence.
Solution Approach 2:
The use of mesh material creates a composite structure combining biological tissue (rectum and sacrum) with synthetic reinforcement (mesh prosthesis). This composite construction provides the mechanical strength needed for durable fixation through the perineal approach, overcoming the weakness of soft tissue-to-soft tissue anchoring that limits perineal rectopexy effectiveness.
3Reliability
If abdominal incision is made for rectal prolapse surgery, then effective rectal fixation is achieved, but scarring and morbidity occur
Solution Approach 1:
The patent inverts the surgical access route from abdominal to perineal, achieving the same fixation goal through a different anatomical pathway. This inversion eliminates the need for abdominal incisions and their resulting scars while maintaining effective rectal-to-sacrum fixation through the perineal route, using the mesh prosthesis to ensure adequate anchoring strength.
4Device complexity
If conventional perineal methods are used for small prolapses, then treatment is simpler, but effectiveness decreases for larger prolapses
Solution Approach 1:
The mesh prosthesis serves as an intermediary that extends the applicability of perineal surgery to larger prolapses. The mesh provides a large surface area for fixation that can accommodate bigger rectal defects, maintaining surgical simplicity through the perineal approach while significantly improving treatment effectiveness for cases that would otherwise require more complex procedures.
Data Source
AI summary
Improved methods and devices for treatment of rectal prolapse are provided. A suturing console for suturing the rectal fascia at, to, or about the sacral vertebral fascia is disclosed. A method of repairing prolapsed rectum via a vaginal incision or perineal incision is also disclosed.