Update on Robotic Rectal Prolapse Treatment

Abstract

Rectal prolapse is a condition that can cause significant social impairment and negatively affects quality of life. Surgery is the mainstay of treatment, with the aim of restoring the anatomy and correcting the associated functional disorders. During recent decades, laparoscopic abdominal procedures have emerged as effective tools for the treatment of rectal prolapse, with the advantages of faster recovery, lower morbidity, and shorter length of stay. Robotic surgery represents the latest evolution in the field of minimally invasive surgery, with the benefits of enhanced dexterity in deep narrow fields such as the pelvis, and may potentially overcome the technical limitations of conventional laparoscopy. Robotic surgery for the treatment of rectal prolapse is feasible and safe. It could reduce complication rates and length of hospital stay, as well as shorten the learning curve, when compared to conventional laparoscopy. Further prospectively maintained or randomized data are still required on long-term functional outcomes and recurrence rates.

Current diagnostic tools and treatment modalities for rectal prolapse

“…Although the outcomes of open, laparoscopic, and robotic repairs are similar, minimally invasive approaches are more common because of faster recovery, lower morbidity, decreased postoperative pain, and lesser blood loss[ 62 , 63 ].…”

“…Although a relatively new technique, ventral mesh rectopexy is the most common procedure for rectal prolapse in Europe[ 63 ]. D’ Hoore first described this technique in 2004; no rectal mobilization or lateral dissection is performed in the original technique, and the lateral ligaments are preserved[ 56 ].…”

“…Robotic surgery is considered more expensive than other techniques; however, after adjusting for the cost of an improved health-related quality of life, the expenditure is almost comparable with that of laparoscopic surgery[ 88 ]. Although reinforcement of the rectovaginal septum is reportedly similar between the robotic and laparoscopic approaches, an improved quality of life has been attributed to a more precise mesh fixation[ 63 ].…”

Treatment of internal rectal prolapse in children: A cross sectional study☆

“…Because such patients refer to different doctors to treat constipation and try various drugs but do not get results, this disease is annoying and resistant to drug treatment with specific symptoms such as difficulty in defecation, severe pain during defecation, elimination in small and hard or soft masses, tightening of the back and redness of the face and sweating during defecation, escaping from sitting on the toilet and preferring to stand Disposal in the corner of the room is unknown to many physicians [ 2 , 3 ]. It is also associated with greater economic burden and reduced quality of life [ 4 ]. Using the experiences of the last ten years about this disease, which have been published in various articles [ 1 ], while providing radiological diagnostic methods and under anesthesia and delshad mash test, the author has treated and achieved successful results.…”

Robotic Gastrointestinal Surgery: State of the Art and Future Perspectives

“…If the results of robotic surgery, in oncological terms, are encouraging, the same can be said for gastrointestinal functional disorders. Even if, on the one hand, robotic surgery proved to be non-inferior to laparoscopic surgery in the treatment of functional esophageal disorders [ 3 ], on the other hand, it showed better postoperative outcomes in the treatment of pelvic floor disorders, such as lower complication rates and shorter lengths of hospital stay [ 4 ].…”