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Techniques in Coloproctology

, Volume 23, Issue 6, pp 529–535 | Cite as

Robotic vs. laparoscopic ventral mesh rectopexy for external rectal prolapse and rectal intussusception: a systematic review

  • S. Albayati
  • P. Chen
  • M. J. Morgan
  • J. W. T. Toh
Review

Abstract

Background

Laparoscopic ventral mesh rectopexy (LVR) is a treatment with promising results in external rectal prolapse, rectal intussusception, and rectocele. Because of the emergence of robotic-assisted surgery and the technical advantage it provides, we examined the potential role and place of robotic surgery in ventral rectopexy.

Methods

MEDLINE, PubMed, and other databases were searched, by two independent reviewers, to identify studies comparing robotic to laparoscopic ventral mesh rectopexy. The primary outcome was the rate of unplanned conversion to open. The secondary outcomes were morbidity, length of hospital stay and recurrence rate.

Results

Five studies (4% male, n = 259) met the inclusion criteria. All 5 studies reported on conversion rate and showed no significant difference between the conversion rate of robotic and laparoscopic groups [OR 0.58 (95% CI 0.09–3.77)]. Robotic surgery was also similar to laparoscopic surgery for both morbidity [OR 0.71 (95% CI 0.34–1.48)] and recurrence rate [OR 0.56 (95% CI 0.18–1.75)]. Operative time was longer in the robotic group with a MWD of 22.88 minutes (CI 5.73–40.04, p < 0.0007). There was a statistically significant reduction in length of stay with robotic surgery [mean difference − 0.36 days (95% CI − 0.66 to − 0.07)].

Conclusions

This systematic review shows that robotic-assisted ventral rectopexy requires longer operative time with no significant added benefit over laparoscopic ventral rectopexy. The conversion rate was low in both groups and the trends to benefit did not reach statistical significance. More studies are required to clarify whether the potential technical advantage of robotic surgery in ventral rectopexy translates to an improvement in clinical outcome.

Keywords

Rectal prolapse Ventral mesh rectopexy Robotic surgery Laparoscopic surgery 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This article does not contain any studies with human participants or animals performed by the authors.

Informed consent

For this type of study formal consent is not required.

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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Department of SurgeryBankstown-Lidcombe HospitalSydneyAustralia
  2. 2.South Western Sydney Clinical SchoolUniversity of New South WalesSydneyAustralia
  3. 3.Department of SurgeryWestmead HospitalSydneyAustralia
  4. 4.Discipline of Surgery, Sydney Medical SchoolUniversity of SydneySydneyAustralia
  5. 5.MoorebankAustralia

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