Robotic vs. laparoscopic ventral mesh rectopexy for external rectal prolapse and rectal intussusception: a systematic review

Albayati, Sinan; Chen, P; Morgan, Matthew J.; Toh, James Wei Tatt

doi:10.1007/s10151-019-02014-w

Cited by 35 publications

(44 citation statements)

References 17 publications

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“…To overcome the problem of postoperative constipation and slow recovery, the concept of ventral rectopexy has been developed [26]. It has the advantage that it can be performed for both external as well as internal rectal prolapse.…”

Section: Surgical Options Technique and Outcomementioning

confidence: 99%

“…Also, it has been reported that minimally invasive approaches reduce the risk of complications and the length of hospital stay [27,28]. There appears to be difference in the recurrence rates between laparoscopic and robotic rectopexy [26]. In another study, comparing open posterior rectopexy to laparoscopic rectopexy in 65 patients, the authors concluded that there was no significant difference between the outcomes achieved from the two procedures [29].…”

Section: Surgical Options Technique and Outcomementioning

confidence: 99%

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Fecal incontinence and rectal prolapse

Kumar

2019

Indian J Gastroenterol

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Fecal incontinence is the involuntary loss of flatus, liquid, or solid stool from the anus. It is more common in women than men. The prevalence of fecal incontinence increases with advancing age. It is either idiopathic or due to injury to the sphincter complex. In women, obstetric trauma is the commonest cause of anal sphincter injury leading to incontinence. Other causes include iatrogenic sphincter injury during hemorrhoidectomy and fistula surgery and acute trauma to the perineum. Overt sphincter damage due to third-or fourth-degree vaginal tears during childbirth has been reported in up to 0.7% of all vaginal deliveries resulting in symptomatic fecal incontinence [1, 2]. The pudendal nerve can also be damaged during childbirth trauma resulting in late development of fecal incontinence [3]. Some patients sustain both mechanical and neurological trauma to the sphincter complex [4]. Risk factors associated with sphincter injury include forceps delivery, primiparous mother, birth weight of the baby > 4 kg, and occipito-posterior presentation. A posterolateral episiotomy does not protect against a sphincter tear [5]. Anal endosonography has enabled accurate imaging of the sphincter complex resulting in accurate recognition of occult anal sphincter defects [6-8]. In one study of 62 women with a history of obstetric trauma, endoanal ultrasonography revealed an external anal sphincter defect in 90% and an internal sphincter defect in 65% of patients [9]. In 8 of the 10 women who had a forceps-assisted delivery, there was evidence of sphincter damage. In another study [10], 127 women who had a vaginal delivery underwent endoanal ultrasonography postpartum. Of the 79 primiparous mothers who had intact sphincters before childbirth, 28 showed damage to one or both sphincter muscles following delivery. The extent of the damage to the sphincter complex was

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Section: Surgical Options Technique and Outcomementioning

confidence: 99%

Section: Surgical Options Technique and Outcomementioning

confidence: 99%

Fecal incontinence and rectal prolapse

Kumar

2019

Indian J Gastroenterol

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“…Our study is the only randomized controlled study comparing LVMR and RVMR. Previous studies have compared RVMR with LVMR in terms of safety, effectiveness, cost and functional outcomes with no superiority of the use of a robot [4,5,8,9,13]. Due to the heterogeneity of the indications for surgery, followup times and imaging techniques in earlier studies, comparison of our findings with the available data must Table 3 MR defaecography and pelvic organ prolapse quantification (POP-Q) measurements, functional and symptom-specific quality of life change from 3 months to 5 years after ventral mesh rectopexy in the total study population.…”

Section: Discussionmentioning

confidence: 99%

“…Current evidence shows no superiority of robot-assisted ventral mesh rectopexy (RVMR) over laparoscopic ventral mesh rectopexy (LVMR) [4,5]. Both techniques have been proved to be safe and effective [6][7][8] with the same results in terms of intra-operative, postoperative and mesh-related complications as well as low recurrence rates [4,[8][9][10][11][12][13].…”

Section: Introductionmentioning

confidence: 99%

Restored pelvic anatomy is preserved after laparoscopic and robot‐assisted ventral rectopexy: MRI‐based 5‐year follow‐up of a randomized controlled trial

et al. 2020

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Aim Our aim was to compare the long-term anatomical outcomes between robot-assisted ventral mesh rectopexy (RVMR) and laparoscopic ventral mesh rectopexy (LVMR) for external or internal rectal prolapse. Method This study is a follow-up of a single-centre randomized controlled trial (RCT). Thirty patients were randomly allocated to RVMR (n = 16) or LVMR (n = 14). The primary end-point was maintenance of the restored pelvic anatomy 5 years after the operation, as assessed by magnetic resonance (MR) defaecography. Secondary outcome measures included the Pelvic Organ Prolapse Quantification (POP-Q) measures and functional results assessed using symptom questionnaires. Results Twenty-six patients (14 RVMR and 12 LVMR) completed the 5-year follow-up and were included in the study. The MRI results, POP-Q measurements and symptom-specific quality of life measures did not differ between the RVMR and LVMR groups. The MRI measurements of the total study population remained unchanged between 3 months and 5 years. In the Pelvic Floor Distress Inventory (PFDI-20), the RVMR group had lower symptom scores (mean 96.0, SD 70.7) than the LVMR group (mean 160.6, SD 58.9; P = 0.004). In the subscales of pelvic organ prolapse (POPDI-6) (mean 23.2, SD 24.3 vs mean 52.4, SD 22.4; P = 0.001) and the Colorectal-Anal Distress Inventory (CRADI-8) (mean 38.4, SD 23.3 vs mean 58.6, SD 25.4; P = 0.009), the patients in the RVMR group had significantly better outcomes. Conclusion After VMR, the corrected anatomy was preserved. There were no clinically significant differences in anatomical results between the RVMR and LVMR procedures 5 years after surgery based on MR defaecography. However, functional outcomes were better after RMVR.

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“…Laparoscopic or robotic approaches are being adopted more commonly. [4][5][6] Recent randomized studies showed no differences in morbidity or recurrence rates between perineal and laparoscopic abdominal approaches. 7 New guidelines also recommend laparoscopic or minimally abdominal approaches for rectal prolapse surgery.…”

mentioning

confidence: 99%

Changing Trend of Rectal Prolapse Surgery in the Era of the Minimally Invasive Surgery

Lee

2019

J Minim Invasive Surg

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With the life span of the general population increased, rectal prolapse in elderly patients became a major concern in terms of the decision of the treatment modalities and quality of life of patients. Most elderly patients with rectal prolapse in the past received a perineal approach with the fear of general anesthetic complications rather than the abdominal approach. However, improvement in perioperative care in anesthesiology and minimally invasive surgery, the trend of surgical management of rectal prolapse is rapidly changing. Minimally invasive surgery including the laparoscopic and robotic surgeries showed comparable short-term outcomes even in elderly patients. Recently published guidelines also recommended a laparoscopic abdominal approach for the management of rectal prolapse.

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Robotic vs. laparoscopic ventral mesh rectopexy for external rectal prolapse and rectal intussusception: a systematic review

Cited by 35 publications

References 17 publications

Fecal incontinence and rectal prolapse

Fecal incontinence and rectal prolapse

Restored pelvic anatomy is preserved after laparoscopic and robot‐assisted ventral rectopexy: MRI‐based 5‐year follow‐up of a randomized controlled trial

Changing Trend of Rectal Prolapse Surgery in the Era of the Minimally Invasive Surgery

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