Anatomical and functional changes to the pelvic floor after robotic versus laparoscopic ventral rectopexy: a randomised study

Abstract

Ventral mesh recto-colpo-sacropexy effectively corrects the anatomy of the posterior compartment, elevates the vaginal apex and reduces pelvic organ mobility of the posterior and middle compartments. The robot-assisted and laparoscopic techniques had similar anatomical and functional outcomes.

Robotic ventral mesh rectopexy for rectal prolapse: a single-institution experience

“…Our study is the first to focus on outcomes of RVMR for rectal prolapse in the USA. Our results corroborate findings from previous studies demonstrating that patients undergoing RVMR for rectal prolapse have symptomatic improvement with minimal morbidity or mortality [3][4][5][6][7][8][9][10][11][12][13][14].…”

“…Indeed, one-third of our patients had a history of attempted rectal prolapse repair with recurrence prior to referral, and nearly 80% of patients had a history of prior pelvic surgery. These rates are higher than the reported 14-16% history of recurrent prolapse and 14-63% history of previous pelvic surgery in cases analyzed in other RVMR series [5,[7][8][9][10]. Despite the complexity of our patient population, we did not have any complications related to the use of mesh or the use of the RVMR technique in our study, whereas reports of complications in the literature on robotic rectal prolapse repair range from 0 to 11% [3,6,9,[12][13][14][15].…”

“…Most of the current literature on RVMR comes from single-institution retrospective reviews in Europe [4][5][6][7][8][9][10][11][12]. Our study is the first to focus on outcomes of RVMR for rectal prolapse in the USA.…”

“…Laparoscopic ventral mesh rectopexy (LVMR) is emerging as the treatment of choice for rectal prolapse in Europe [3]. More recently, ventral mesh rectopexy has been performed using a robotic approach with evidence supporting feasibility, safety and good functional outcomes [3][4][5][6][7][8][9][10][11][12][13][14][15][16]. A robotic approach is a particularly useful technique in the restricted space of the pelvis due to enhanced visibility from greater field magnification and three-dimensional imaging, as well as improved dexterity from the use of multiarticulated instruments, elimination of physiologic tremor and an improved eye-hand-target axis [17,18].…”

“…In addition, there is evidence to suggest that compared to laparoscopic surgery, robotic surgery may provide ergonomic benefits for the surgeon [19,20]. Most reports of robotic ventral mesh rectopexy (RVMR) come from singleinstitution reviews in Europe and typically include a combined analysis of RVMR along with other types of laparoscopic and/or robotic surgery for rectal prolapse [4][5][6][7][8][9][10][11][12][13][14]. To our knowledge, this report is the first to focus on outcomes of RVMR for rectal prolapse in the USA.…”