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Techniques in Coloproctology

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01-06-2019 | Rectal Prolapse | Review

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

Authors: S. Albayati, P. Chen, M. J. Morgan, J. W. T. Toh

Published in: Techniques in Coloproctology | Issue 6/2019

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.

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Title: Robotic vs. laparoscopic ventral mesh rectopexy for external rectal prolapse and rectal intussusception: a systematic review
Authors: S. Albayati
P. Chen
M. J. Morgan
J. W. T. Toh
Publication date: 01-06-2019
Publisher: Springer International Publishing
Keywords: Rectal Prolapse
Rectopexy
Published in: Techniques in Coloproctology / Issue 6/2019
Print ISSN: 1123-6337
Electronic ISSN: 1128-045X
DOI: https://doi.org/10.1007/s10151-019-02014-w

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

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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