As noted in a previous blog, ventral mesh rectopexy is the most durable, effective method of treating rectal prolapse. However, I am often asked about the safety of placing mesh in the pelvis and if there is an increased risk of complications with mesh placement. Of note, I believe strongly in patient autonomy, education and shared decision making. All concerns are valid concerns and no doctor or surgeon should force any patient into a procedure where they feel uncomfortable. That said, I want to discuss the safety profile of ventral mesh rectopexy for those who have concerns about the mesh. 

1. Mesh Safety: Many patients worry about the use of mesh due to concerns about complications, such as infection or mesh erosion. There have been reports of issues with mesh used in other types of surgical procedures, leading to concerns about its safety. According to the most recent data, mesh related complications with robotic ventral mesh rectopexy occur in approximately 1-4% of patients with most studies reporting under 2% complication rates. 

2. Type of Mesh: There are two categories of mesh that can be used: synthetic and biologic. Synthetic mesh is permanent and over time, it is incorporated into a patient’s tissues. Biologic mesh is eventually dissolved by the patient’s body but generally takes a long time - 1-2 years - to dissolve. Studies have shown a slightly decreased risk of mesh infection and erosion with biologic mesh placement, however those studies did not show a significant difference between the two. Overall, the risk of complications with either type of mesh during ventral mesh rectopexy is relatively low, and the benefits often outweigh the potential risks.

3. Individualized Care: Patient safety and satisfaction are paramount. Colorectal surgeons tailor the treatment approach to each patient's unique needs, ensuring that mesh or non-mesh options are chosen based on the individual's condition and risk factors. This personalized approach maximizes safety and effectiveness.

In conclusion, the concerns patients have about mesh in rectopexy are valid, but it's crucial to understand that the use of mesh for the treatment of rectal prolapse is safe and backed by research. Patients should consult with a qualified colorectal surgeon with a focus in pelvic floor diseases to determine the most appropriate treatment option for their specific situation. This individualized care approach ensures the best outcome for rectal prolapse repair while prioritizing patient safety and well-being.