Skip to main content

Robotic Rectal Prolapse Repair

  • Chapter
  • First Online:
Robotic Surgery

Abstract

This chapter gives a comprehensive overview of the current standards in the evaluation and surgical management of rectal prolapse, using the Da Vinci surgical system. Rectal prolapse is a disabling condition mostly seen in middle-aged women. The rectal wall protruding in or through the anal canal can lead to symptoms of obstructed defecation and fecal incontinence. A thorough preoperative multi-disciplinary evaluation of patients with rectal prolapse should be performed to look for concomitant prolapse of the middle and anterior pelvic floor compartments. The only definite treatment for rectal prolapse is surgery. This aims at correcting the abnormal anatomy and relieving the associated functional complaints. Numerous procedures have been described including perianal and abdominal approaches and open and minimally invasive techniques. Although there is no international consensus on preferred treatment strategy, currently the two most widely applied surgeries are the ventral rectopexy and the resection rectopexy. Both procedures have been shown safe and feasible performed by either laparoscopy or robot-assisted. Robot-assisted procedures seem to be advantageous in rectal prolapse surgery due to its enhanced maneuverability while performing dissection and suturing deep down the narrow pelvis.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 169.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 219.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 299.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Wu JS. Rectal prolapse: a historical perspective. Curr Probl Surg. 2009;46(8):602–716. https://doi.org/10.1067/j.cpsurg.2009.03.006.

    Article  PubMed  Google Scholar 

  2. Wijffels NA, Collinson R, Cunningham C, Lindsey I. What is the natural history of internal rectal prolapse? Color Dis. 2010;12(8):822–30. https://doi.org/10.1111/j.1463-1318.2009.01891.x.

    Article  CAS  Google Scholar 

  3. Elneil S. Complex pelvic floor failure and associated problems. Best Pract Res Clin Gastroenterol. 2009;23(4):555–73. https://doi.org/10.1016/j.bpg.2009.04.011.

    Article  PubMed  Google Scholar 

  4. Madiba TE, Baig MK, Wexner SD. Surgical management of rectal prolapse. Arch Surg. 2005;140(1):63–73. https://doi.org/10.1001/archsurg.140.1.63.

    Article  PubMed  Google Scholar 

  5. Formijne Jonkers HA, Draaisma WA, Wexner SD, et al. Evaluation and surgical treatment of rectal prolapse: an international survey. Color Dis. 2013;15(1):115–9. https://doi.org/10.1111/j.1463-1318.2012.03135.x.

    Article  CAS  Google Scholar 

  6. Kuijpers HC. Treatment of complete rectal prolapse: to narrow, to wrap, to suspend, to fix, to encircle, to plicate or to resect? World J Surg. 1992;16(5):826–30. https://doi.org/10.1007/BF02066977.

    Article  CAS  PubMed  Google Scholar 

  7. D’Hoore A, Cadoni R, Penninckx F. Long-term outcome of laparoscopic ventral rectopexy for total rectal prolapse. Br J Surg. 2004; https://doi.org/10.1002/bjs.4779.

  8. Frykman HMGS. The surgical treatment of rectal procidentia. Surg Gynecol Obs. 1969;129(6):1225–30.

    CAS  Google Scholar 

  9. Laubert T, Kleemann M, Schorcht A, et al. Laparoscopic resection rectopexy for rectal prolapse: a single-center study during 16 years. Surg Endosc. 2010;24(10):2401–6. https://doi.org/10.1007/s00464-010-0962-9.

    Article  PubMed  Google Scholar 

  10. Ayav A, Bresler L, Hubert J, Brunaud L, Boissel P. Robotic-assisted pelvic organ prolapse surgery. Surg Endosc. 2005;19(9):1200–3. https://doi.org/10.1007/s00464-004-2257-5.

    Article  CAS  PubMed  Google Scholar 

  11. Heemskerk J, De Hoog DENM, Van Gemert WG, Baeten CGMI, Greve JWM, Bouvy ND. Robot-assisted vs. conventional laparoscopic rectopexy for rectal prolapse: a comparative study on costs and time. Dis Colon Rectum. 2007; https://doi.org/10.1007/s10350-007-9017-2.

  12. Albayati S, Chen P, Morgan MJ, Toh JWT. Robotic vs. laparoscopic ventral mesh rectopexy for external rectal prolapse and rectal intussusception: a systematic review. Tech Coloproctol. 2019;23(6):529–35. https://doi.org/10.1007/s10151-019-02014-w.

    Article  CAS  PubMed  Google Scholar 

  13. Bordeianou L, Paquette I, Johnson E, et al. Clinical practice guidelines for the treatment of rectal prolapse. Dis Colon Rectum. 2017;60(11):1121–31. https://doi.org/10.1097/DCR.0000000000000889.

    Article  PubMed  Google Scholar 

  14. D’Hoore A, Penninckx F. Laparoscopic ventral recto(colpo)pexy for rectal prolapse: Surgical technique and outcome for 109 patients. Surg Endosc Other Interv Tech. 2006. https://doi.org/10.1007/s00464-005-0485-y.

  15. Carrington EV, Heinrich H, Knowles CH, et al. The international anorectal physiology working group (IAPWG) recommendations: standardized testing protocol and the London classification for disorders of anorectal function. Neurogastroenterol Motil. 2019:e13679. https://doi.org/10.1111/nmo.13679.

  16. van Iersel JJ, Formijne Jonkers HA, Verheijen PM, et al. Comparison of dynamic magnetic resonance defaecography with rectal contrast and conventional defaecography for posterior pelvic floor compartment prolapse. Color Dis. 2017;19(1):O46–53. https://doi.org/10.1111/codi.13563.

    Article  Google Scholar 

  17. Ramage L, Simillis C, Yen C, et al. Magnetic resonance defecography versus clinical examination and fluoroscopy: a systematic review and meta-analysis. Tech Coloproctol. 2017;21(12):915–27. https://doi.org/10.1007/s10151-017-1704-y.

    Article  CAS  PubMed  Google Scholar 

  18. Formijne Jonkers HA, van de Haar HJ, Draaisma WA, Heggelman BGF, Consten ECJ, Broeders IAMJ. The optimal strategy for proximal mesh fixation during laparoscopic ventral rectopexy for rectal prolapse: an ex vivo study. Surg Endosc. 2012;26(8):2208–12. https://doi.org/10.1007/s00464-012-2161-3.

    Article  PubMed  Google Scholar 

  19. Formijne Jonkers HA, Maya A, Draaisma WA, et al. Laparoscopic resection rectopexy versus laparoscopic ventral rectopexy for complete rectal prolapse. Tech Coloproctol. 2014;18(7):641–6. https://doi.org/10.1007/s10151-014-1122-3.

    Article  CAS  PubMed  Google Scholar 

  20. Emile SH, Elfeki HA, Youssef M, Farid M, Wexner SD. Abdominal rectopexy for the treatment of internal rectal prolapse: a systematic review and meta-analysis. Color Dis. 2017;19(1):O13–24. https://doi.org/10.1111/codi.13574.

    Article  CAS  Google Scholar 

  21. van Iersel JJ, Paulides TJC, Verheijen PM, Lumley JW, Broeders IAMJ, Consten ECJ. Current status of laparoscopic and robotic ventral mesh rectopexy for external and internal rectal prolapse. World J Gastroenterol. 2016;22(21):4977–87. https://doi.org/10.3748/wjg.v22.i21.4977.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Consten ECJ, van Iersel JJ, Verheijen PM, Broeders IAMJ, Wolthuis AM, D’Hoore A. Long-term outcome after laparoscopic ventral mesh rectopexy: an observational study of 919 consecutive patients. Ann Surg. 2015;262(5):742–8. https://doi.org/10.1097/SLA.0000000000001401.

    Article  PubMed  Google Scholar 

  23. Schraffordt Koops SE, De Witte CJ, Consten ECJ, Broeders IAMJ, Van Iersel J. Robot-assisted sacrocolporectopexy for multi-compartment prolapse of the pelvic floor: a prospective cohort study evaluating functional and sexual outcome. J Minim Invasive Gynecol. 2016;23(7):S11–2.

    Article  Google Scholar 

  24. Jallad K, Ridgeway B, Paraiso MFR, Gurland B, Unger CA. Long-term outcomes after ventral rectopexy with sacrocolpo- or hysteropexy for the treatment of concurrent rectal and pelvic organ prolapse. Female Pelvic Med Reconstr Surg. 2017. https://doi.org/10.1097/SPV.0000000000000444.

  25. Balla A, Quaresima S, Smolarek S, Shalaby M, Missori G, Sileri P. Synthetic versus biological mesh-related erosion after laparoscopic ventral mesh rectopexy: a systematic review. Ann Coloproctol. 2017;33(2):46–51. https://doi.org/10.3393/ac.2017.33.2.46.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Smart NJ, Pathak S, Boorman P, Daniels IR. Synthetic or biological mesh use in laparoscopic ventral mesh rectopexy – a systematic review. Color Dis. 2013;15(6):650–4. https://doi.org/10.1111/codi.12219.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to E. C. J. Consten .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2021 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

van der Schans, E.M., Verheijen, P.M., Broeders, I.A.M.J., Consten, E.C.J. (2021). Robotic Rectal Prolapse Repair. In: Gharagozloo, F., Patel, V.R., Giulianotti, P.C., Poston, R., Gruessner, R., Meyer, M. (eds) Robotic Surgery. Springer, Cham. https://doi.org/10.1007/978-3-030-53594-0_142

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-53594-0_142

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-53593-3

  • Online ISBN: 978-3-030-53594-0

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics