Robot‐assisted vs laparoscopic ventral rectopexy for external or internal rectal prolapse and enterocele: a randomized controlled trial

Abstract

Robot-assisted laparoscopic ventral rectopexy can be performed safely and within the same operative time as conventional laparoscopy. Minimally invasive ventral rectopexy allows good anatomical correction as assessed by MR defaecography, with no differences between the techniques.

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

“…In LVMR, dissection extends to the levator plane and mesh fixation is placed as caudal to the rectum as possible. Most importantly, this corrects the invaginating rectal wall and diminishes the rectocele and obliterates the enterocele [16]. It also provides support to the vaginal apex, which is the keystone of pelvic floor support [6].…”

“…This study is a part of a prospective randomised control series comparing robot-assisted and laparoscopic ventral rectopexy operations registered in Current Controlled Trials, ISRCTN88884232 [16]. Primary outcome measures were the postoperative changes to the comprehensive pelvic floor anatomy, mobility and function assessed using the ICS POP-Q method, dynamic MR defecography and symptom questionnaires.…”

“…Primary outcome measures were the postoperative changes to the comprehensive pelvic floor anatomy, mobility and function assessed using the ICS POP-Q method, dynamic MR defecography and symptom questionnaires. The perioperative parameters and complications have been described elsewhere [16].…”

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

“…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.…”