Long-term outcomes of robot-assisted versus laparoscopic ventral mesh rectopexy for rectal prolapse and rectal intussusception

Abstract

Abstract Purpose The aim of this study is to compare short- and long-term outcomes following robot-assisted (RVR) and laparoscopic (LVR) ventral mesh rectopexy in patients with external rectal prolapse and rectal intussusception. Methods All consecutive patients undergoing LVR or RVR between April 2015 and June 2018 were included in this study. Patients were contacted by mail or phone for follow ups at one year, and up to 6 years post surgery. St Mark’s, Cleveland Clinic constipation score (CCCS), and Gastrointestinal Quality of Life Index (GIQLI) were obtained before surgery and at each follow up. Results Sixty-one patients had ventral mesh rectopexy, 34 robot-assisted and 27 laparoscopic. Mean operative time was longer in the RVR group compared to LVR (237 vs 182 minutes, P < 0.01). There were three postoperative complications in the LVR group compared to one in the RVR group (11% vs. 3%, P = 0.2). Median length of hospital stay was 2 days in both groups (P = 0.09). Recurrence rate for patients with external rectal prolapse was 10% in both groups (P = 1). Median St Mark’s score, CCCS, and GIQLI significantly improved following both laparoscopic and robot-assisted ventral mesh rectopexy. Conclusion Both laparoscopic and robot-assisted ventral mesh rectopexy are safe and effective techniques in patients with external rectal prolapse and rectal intussusception. Except for prolonged operative time with RVR, there are no significant differences in short-term outcomes between the two groups. Both techniques significantly improve, faecal incontinence, obstructed defaecation and quality of life in patients with rectal prolapse and rectal intussusception.