Day case robotic ventral rectopexy compared with day case laparoscopic ventral rectopexy: a prospective study
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Ventral rectopexy to the promontory has become one of the most strongly advocated surgical treatments for patients with full-thickness rectal prolapse and deep enterocele. Despite its challenges, laparoscopic ventral rectopexy with or without robotic assistance for selected patients can be performed with relatively minimal patient trauma thus creating the potential for same-day discharge. The aim of this prospective case–controlled study was to assess the feasibility, safety, and cost of day case robotic ventral rectopexy compared with routine day case laparoscopic ventral rectopexy.
Between February 28, 2014 and March 3, 2015, 20 consecutive patients underwent day case laparoscopic ventral rectopexy for total rectal prolapse or deep enterocele at Michallon University Hospital, Grenoble. Patients were selected for day case surgery on the basis of motivation, favorable social circumstances, and general fitness. One out of every two patients underwent the robotic procedure (n = 10). Demographics, technical results, and costs were compared between both groups.
Patients from both groups were comparable in terms of demographics and technical results. Patients operated on with the robot had significantly less pain (p = 0.045). Robotic rectopexy was associated with longer median operative time (94 vs 52.5 min, p < 0.001) and higher costs (9088 vs 3729 euros per procedure, p < 0.001) than laparoscopic rectopexy.
Day case robotic ventral rectopexy is feasible and safe, but results in longer operative time and higher costs than classical laparoscopic ventral rectopexy for full-thickness rectal prolapse and enterocele.
KeywordsRectal prolapse Robotic surgery Laparoscopy Rectopexy Day case surgery Minimally invasive surgery
Special thanks to Genevieve Trilling for English proofreading, to Dr. Martine Richard, MD, and Mrs Sofia Kowalski who provided ambulatory data results, to Prof. Jean-Luc Bosson, MD, PhD, who provided methodology support and review, and to Mrs Kristina Skåre who provided statistical expertise.
Compliance with ethical standards
Conflict of interest
Prof. Jean-Luc Faucheron received honoraria for punctual interventions, punctual consultancies and had some reimbursed travels and prepaid subscriptions for meetings from AMI, Covidien, Medtronic, Ethicon, MSD, Legrand, and Johnson & Johnson. Dr. Fabian Reche has a commercial relationship with Endocontrol as a consultant and has been reimbursed for travel and meeting subscriptions by Covidien, Baxter, AMI, and Leo Pharma. Drs. Sandrine Barbois, Bertrand Trilling, Pierre-Yves Sage, and Pierre-Alexandre Waroquet have no conflicts of interest to disclose.
All procedures performed in this study were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments.
For this study, patients have signed an informed consent.
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