Robotic Ventral Rectopexy for Rectal Prolapse

Rectal prolapse or procidentia is a debilitating condition that typically presents in parous older women but can occur in men and women of all ages. Surgery is the mainstay for the treatment of rectal prolapse and can be performed through a transabdominal or a perineal approach. Ventral mesh rectopexy was first described by D’Hoore in 2004 and involves pure anterior rectal mobilization to reduce the risk of autonomic nerve injury and postoperative constipation. The need for dissecting along the rectovaginal (or rectovesical) septum as well as suturing within the confined space of the deep pelvis makes ventral mesh rectopexy a procedure ideally suited for robotic surgery. Data from recent meta-analyses suggest that the robotic platform may reduce intraoperative blood loss, length of hospital stay, and postoperative complication rates when compared with conventional laparoscopy. Prospective data on long-term functional outcomes and recurrence are needed.