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01-09-2011 | Original Article

Robotic sacrocolpoperineopexy with ventral rectopexy for the combined treatment of rectal and pelvic organ prolapse: initial report and technique

Authors: Jhansi Reddy, Beri Ridgeway, Brooke Gurland, Marie Fidela R. Paraiso

Published in: Journal of Robotic Surgery | Issue 3/2011

Abstract

The objective of our study is to describe the peri-operative and early postoperative surgical outcomes following robotic sacrocolpoperineopexy with ventral rectopexy for the combined treatment of rectal and pelvic organ prolapse. This was a retrospective cohort study of ten women with symptomatic Stage 2 or greater pelvic organ prolapse and concomitant rectal prolapse who desired combined robotic surgery, at a single institution. The mean age of the subjects was 55.3 ± 19.2 years (range 19–86) and the mean body mass index was 25.8 ± 5.7 kg/m². Preoperatively, the women had Stage 2 or greater pelvic organ prolapse and the average length of rectal prolapse was 2.1 ± 1.9 cm. There were no conversions to conventional laparoscopy or laparotomy. The mean operating room time was 307 ± 45 min with an estimated blood loss of 144 ± 68 ml. The average length of stay was 2.4 ± 0.8 days. Preliminary data suggest that robotic sacrocolpoperineopexy with ventral rectopexy is a feasible procedure with minimal operative morbidity for the combined treatment of rectal and pelvic organ prolapse. Longer follow-up is needed to ensure favorable long-term subjective and objective outcomes.

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Nygaard I, Barber MD, Burgio KL et al (2008) Prevalence of symptomatic pelvic floor disorders in US women. JAMA 300:1311–1316PubMedCrossRef

Wu JM, Hundley AF, Fulton RG et al (2009) Forecasting the prevalence of pelvic floor disorders in US women: 2010 to 2050. Obstet Gynecol 114:1278–1283PubMedCrossRef

Subak LL, Waetjen LE, van den Eeden S et al (2001) Cost of pelvic organ prolapse surgery in the United States. Obstet Gynecol 98:646–651PubMedCrossRef

Sullivan ES, Longaker CJ, Lee PY (2001) Total pelvic mesh repair: a ten-year experience. Dis Colon Rectum 44:857–863PubMedCrossRef

Ayav A, Bresler L, Brunaud L et al (2005) Surgical management of combined rectal and genital prolapse in young patients: transabdominal approach. Int J Colorectal Dis 20:173–179PubMedCrossRef

Sagar PM, Thekkinkattil DK, Heath RM et al (2008) Feasibility and functional outcome of laparoscopic sacrocolporectopexy for combined vaginal and rectal prolapse. Dis Colon Rectum 51:1414–1420PubMedCrossRef

Geller EJ, Siddiqui NY, Wu JM et al (2008) Short-term outcomes of robotic sacrocolpopexy compared with abdominal sacrocolpopexy. Obstet Gynecol 112:1201–1206PubMedCrossRef

Lim M, Sagar PM, Gonsalves S et al (2007) Surgical management of pelvic organ prolapse in females: functional outcome of mesh sacrocolpopexy and rectopexy as a combined procedure. Dis Colon Rectum 50:1412–1421PubMedCrossRef

Riansuwan W, Hull TL, Bast J et al (2010) Combined surgery in pelvic organ prolapse is safe and effective. Colorectal Dis 12:188–192PubMedCrossRef

10.

Boccasanta P, Venturi M, Spennacchio M et al (2010) Prospective clinical and functional results of combined rectal and urogynecologic surgery in complex pelvic floor disorders. Am J Surg 199:144–153PubMedCrossRef

11.

Bump RC, Mattiasson A, Bo K et al (1996) The standardization of terminology of female pelvic organ prolapse and pelvic floor dysfunction. Am J Obstet Gynecol 175:10–17PubMedCrossRef

12.

Hodde J, Hiles M (2007) Constructive soft tissue remodeling with a biologic extracellular matrix graft: overview and review of the clinical literature. Acta Chir Belg 107:641–647PubMed

13.

Stepp KJ, Walters MD (2007) Anatomy of the lower urinary tract, rectum, and pelvic floor. In: Walters MD, Karram MM (eds) Urogynecology and reconstructive pelvic surgery, 3rd edn. Elsevier, Philadelphia, pp 17–30

14.

Gordon D, Groutz A, Goldman G et al (1999) Anal incontinence: prevalence among female patients attending urogynecologic clinic. Neurourol Urodyn 18:199–204PubMedCrossRef

15.

Jackson SL, Weber AM, Hull TL et al (1997) Fecal incontinence in women with urinary incontinence and pelvic organ prolapse. Obstet Gynecol 89:423–427PubMedCrossRef

16.

Ellerkmann RM, Cundiff GW, Melick CF et al (2001) Correlation of symptoms with location and severity of pelvic organ prolapse. Am J Obstet Gynecol 185:1332–1337PubMedCrossRef

17.

Steele SR, Lee P, Mullenix PS et al (2006) Is there a role for concomitant pelvic floor repair in patients with sphincter defects in the treatment of fecal incontinence? Int J Colorectal Dis 21:508–514PubMedCrossRef

18.

Darai E, Countant C, Rouzier R et al (2009) Genital prolapse repair using porcine skin implant and bilateral sacrospinous fixation: midterm functional outcome and quality-of-life assessment. Urology 73:245–250PubMedCrossRef

19.

Ellis CN (2008) Outcomes after repair of repair of rectovaginal fistulas using bioprosthetics. Dis Colon Rectum 51:1084–1088PubMedCrossRef

20.

Williams NS, Giordano P, Dvorkin LS et al (2005) External pelvic rectal suspension (the express procedure) for full-thickness rectal prolapse: evolution of a new technique. Dis Colon Rectum 48:307–316PubMedCrossRef

21.

Kropp BP, Cheng EY, Pope JC IV et al (2002) Use of small intestinal submucosa for corporal body grafting in cases of severe penile curvature. J Urol 168:1742–1745PubMedCrossRef

Title: Robotic sacrocolpoperineopexy with ventral rectopexy for the combined treatment of rectal and pelvic organ prolapse: initial report and technique
Authors: Jhansi Reddy
Beri Ridgeway
Brooke Gurland
Marie Fidela R. Paraiso
Publication date: 01-09-2011
Publisher: Springer-Verlag
Published in: Journal of Robotic Surgery / Issue 3/2011
Print ISSN: 1863-2483
Electronic ISSN: 1863-2491
DOI: https://doi.org/10.1007/s11701-011-0257-8

At a glance: The STEP trials

Springer Medicine

Robotic sacrocolpoperineopexy with ventral rectopexy for the combined treatment of rectal and pelvic organ prolapse: initial report and technique

Abstract

At a glance: The STEP trials

Springer Medicine

Abstract

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