Mesh in laparoscopic rectopexy has caused controversy because of mesh-related complications. Suture rectopexy cannot be mastered by surgeons who are not competent in laparoscopic suturing. The use of Protack staples may be providing an answer to the technical problem of securing the rectum onto the sacrum, as this recent study shows.
Lately there have been several concerns about safety of synthetic mesh for surgery in the pelvis. Migration of the mesh, erosion into adjacent bowel, formation of dense adhesions and chronic pain have been described in several studies and there also have been some high profile legal cases. The alternative use of biological mesh has been tried, however the main problem with that is the extremely high cost of that mesh. Biological mesh also has less strength and shrinks more than synthetic mesh and its long term efficacy has not been reported yet.