Techniques in Coloproctology

, Volume 18, Issue 2, pp 151–155 | Cite as

Robotic-assisted and laparoscopic ventral rectopexy in the treatment of rectal prolapse: a matched-pairs study of operative details and complications

  • J. Mäkelä-KaikkonenEmail author
  • T. Rautio
  • K. Klintrup
  • H. Takala
  • M. Vierimaa
  • P. Ohtonen
  • J. Mäkelä
Original Article



Laparoscopic ventral rectopexy has been proven to be safe and effective in the treatment of rectal prolapse or intussusception. Robotic-assisted surgery may offer potential benefits to this operation. This study describes the comparison of robotic-assisted and conventional laparoscopic ventral rectopexy in terms of clinical parameters, operative details, postoperative complications and short-term outcomes.


Twenty patients operated on for rectal prolapse or intussusception using the Da Vinci Surgical System (Intuitive Surgical Inc, Sunnyvale CA, USA) were prospectively followed for 3 months. The cases were pair-matched with laparoscopically operated controls from registry files.


Mean operating time was 159 min (standard deviation; ±37 SD) and 153 min (±33 SD) and mean total time in the operating theatre 231 min (±39 SD) and 234 min (±41 SD) for robotic-assisted and laparoscopic operations, respectively. Mean blood loss was 25 ml (±49 SD) in robotic-assisted and 37 ml (±50 SD) in laparoscopic procedures. There was one (5 %) significant complication in each group. Mean length of hospital stay was 3.1 (±2 SD) and 3.3 (±1.3 SD) days for the robotic-assisted and laparoscopic groups, respectively. The subjective benefit rate was the same in both groups: 16/20 (80 %). One patient in the robotic-assisted group continued to have symptoms of obstructed defecation, and there was one recurrence of prolapse in the laparoscopic group.


Robotic-assisted laparoscopic ventral rectopexy is safe, feasible and not more time consuming than the laparoscopic technique even at the beginning of the learning curve. The short-term results are comparable with those of laparoscopy. We found no arguments to support the routine use of robotic assistance in rectopexy operations.


Ventral rectopexy Laparoscopic Robotic Rectal prolapse Intussusception 


Conflict of interest


Supplementary material

Supplementary material (wmv 550 Mb)


  1. 1.
    Madiba TE, Baig MK, Wexner SD (2005) Surgical management of rectal prolapse. Arch Surg 140:63–73PubMedCrossRefGoogle Scholar
  2. 2.
    Penninckx F, D’Hoore A, Sohier S, Kerremans R (1997) Abdominal resection rectopexy versus Delorme’s procedure for rectal prolapse: a predictable outcome. Int J Colorectal Dis 12:49–50PubMedCrossRefGoogle Scholar
  3. 3.
    Munz Y, Moorthy K, Kudchadkar R et al (2004) Robotic assisted rectopexy. Am J Surg 187:88–92PubMedCrossRefGoogle Scholar
  4. 4.
    Wong MT, Meurette G, Rigaud J, Regenet N, Lehur PA (2011) Robotic versus laparoscopic rectopexy for complex rectocele: a prospective comparison of short-term outcomes. Dis Colon Rectum 54:342–346PubMedCrossRefGoogle Scholar
  5. 5.
    Baik SH (2008) Robotic colorectal surgery. Yonsei Med J 49:891–896PubMedCentralPubMedCrossRefGoogle Scholar
  6. 6.
    Heemskerk J, Zandbergen R, Maessen JG, Greve JW, Bouvy ND (2006) Advantages of advanced laparoscopic systems. Surg Endosc 20:730–733PubMedCrossRefGoogle Scholar
  7. 7.
    Maeso S, Resa M, Mayol JA et al (2010) Efficacy of the Da Vinci Surgical System in abdominal surgery compared with that of laparoscopy, a systematic review and meta-analysis. Ann Surg 252:254–262PubMedCrossRefGoogle Scholar
  8. 8.
    Ayav A, Bresler L, Hubert J, Brunaud L, Boissel P (2005) Robotic-assisted pelvic organ prolapse surgery. Surg Endosc 19:1200–1203PubMedCrossRefGoogle Scholar
  9. 9.
    de Hoog DE, Heemskerk J (2009) Recurrence and functional results after open versus conventional versus robot-assisted laparoscopic rectopexy for rectal prolapse: a case-control study. Int J Colorectal Dis 24:1201–1206PubMedCentralPubMedCrossRefGoogle Scholar
  10. 10.
    D’Hoore A, Penninckx F (2006) Laparoscopic ventral recto(colpo)pexy for rectal prolapse: surgical technique and outcome for 109 patients. Surg Endosc 20:1919–1923PubMedCrossRefGoogle Scholar
  11. 11.
    Heemskerk J, de Hoog D, van Gemert WG, Baeten CG, Greve JW, Bouvy MD (2007) Robot assisted vs conventional laparoscopic rectopexy for rectal prolapse: a comparative study on costs and time. Dis Colon Rectum 50:1825–1830PubMedCentralPubMedCrossRefGoogle Scholar
  12. 12.
    Bokhari M, Patel C, Ramos-Valadez D, Ragupathi M, Haas E (2011) Learning curve for robotic-assisted laparoscopic colorectal surgery. Surg Endosc 25:855–860PubMedCentralPubMedCrossRefGoogle Scholar
  13. 13.
    Miskovic D, Ni M, Wyles SM, Tekkis P, Hanna GB (2012) Learning curve and case selection in laparoscopic colorectal surgery: systematic review and international multicenter analysis of 4,852 cases. Dis Colon Rectum 55:1300–1310PubMedCrossRefGoogle Scholar
  14. 14.
    Lebeau T, Rouprêt M, Ferhi K et al (2011) The role of a well-trained team on the early learning curve of robot-assisted laparoscopic procedures: the example of radical prostatectomy. Int J Med Robot. doi: 10.1002/rcs435 PubMedGoogle Scholar
  15. 15.
    Heemskerk J, van Gemert WG, Greve JW, Bouvy ND (2007) Robot-assisted versus conventional laparoscopic Nissen fundoplication: a comparative retrospective study on costs and time consumption. Surg Laparosc Endosc Percutan Tech 17:1–4PubMedCrossRefGoogle Scholar
  16. 16.
    Chitwood WR Jr, Nifong LW, Chapman WH et al (2001) Robotic surgical training in an academic institution. Am Surg 234:475–484Google Scholar
  17. 17.
    D’Hoore A, Cadoni R, Penninckx F (2004) Long-term outcome of laparoscopic ventral rectopexy for total rectal prolapse. Br J Surg 91:1500–1505PubMedCrossRefGoogle Scholar
  18. 18.
    Slawik S, Soulsby R, Carter H, Payne H, Dixon AR (2008) Laparoscopic ventral rectopexy, posterior colporrhaphy and vaginal sacrocolpopexy for the treatment of recto-genital prolapse and mechanical outlet obstruction. Colorectal Dis 10:138–143PubMedGoogle Scholar
  19. 19.
    Lauretta A, Bellomo RE, Galanti F, Tonizzo CA, Infantino A (2012) Laparoscopic low ventral rectocolpopexy (LLVR) for rectal and rectogenital prolapse: surgical technique and functional results. Tech Coloproctol 16:477–483PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Italia 2013

Authors and Affiliations

  • J. Mäkelä-Kaikkonen
    • 1
    Email author
  • T. Rautio
    • 1
  • K. Klintrup
    • 1
  • H. Takala
    • 1
  • M. Vierimaa
    • 1
  • P. Ohtonen
    • 1
  • J. Mäkelä
    • 1
  1. 1.Division of Gastroenterology, Department of SurgeryUniversity Hospital of OuluOuluFinland

Personalised recommendations