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Minimally Invasive Surgery for Rectal Prolapse: Robotic Procedures

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Abstract

Robotic surgery is a safe technique for the treatment of rectal prolapse with specific advantages over both open abdominal and laparoscopic techniques. Robotic surgery provides high-quality, three-dimensional visualization of the pelvic anatomy while providing easier dissection of the rectovaginal septum and easier suturing in the deep pelvis compared to laparoscopic techniques. These advantages make robotic surgery ideally suited for minimally invasive ventral rectopexy; a technique with a proven low recurrence rate and excellent functional outcomes. Although robotic surgery is associated with longer operative times, recent studies have shown that the time of the procedure decreases with increased experience and there is ultimately not a significant difference between robotic and laparoscopic surgery. The major disadvantage of robotic surgery still remains a higher hospital cost compared with laparoscopy and open techniques. There is limited clinical data regarding the benefits of robotic surgery and further prospective clinical trials are needed to affirm the role of robotic surgery in the treatment of rectal prolapse.

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References

  1. Classic articles in colonic and rectal surgery. Edmond Delorme 1847–1929. On the treatment of total prolapse of the rectum by excision of the rectal mucous membranes or recto-colic. Dis Colon Rectum. 1985;28(7):544–553.

    Google Scholar 

  2. Kuijpers HC. Treatment of complete rectal prolapse: to narrow, to wrap, to suspend, to fix, to encircle, to plicate or to resect? World J Surg. 1992;16(5):826–30.

    Article  CAS  PubMed  Google Scholar 

  3. Jacobs LK, Lin YJ, Orkin BA. The best operation for rectal prolapse. Surg Clin North Am. 1997;77(1):49–70.

    Article  CAS  PubMed  Google Scholar 

  4. Kim DS, Tsang CB, Wong WD, Lowry AC, Goldberg SM, Madoff RD. Complete rectal prolapse: evolution of management and results. Dis Colon Rectum. 1999;42(4):460–6. discussion 466-469.

    Article  CAS  PubMed  Google Scholar 

  5. Kairaluoma MV, Viljakka MT, Kellokumpu IH. Open vs. laparoscopic surgery for rectal prolapse: a case-controlled study assessing short-term outcome. Dis Colon Rectum. 2003;46(3):353–60.

    Article  PubMed  Google Scholar 

  6. Kariv Y, Delaney CP, Casillas S, et al. Long-term outcome after laparoscopic and open surgery for rectal prolapse: a case-control study. Surg Endosc. 2006;20(1):35–42.

    Article  CAS  PubMed  Google Scholar 

  7. Purkayastha S, Tekkis P, Athanasiou T, et al. A comparison of open vs. laparoscopic abdominal rectopexy for full-thickness rectal prolapse: a meta-analysis. Dis Colon Rectum. 2005;48(10):1930–40.

    Article  PubMed  Google Scholar 

  8. Kessler H, Hohenberger W. Laparoscopic resection rectopexy for rectal prolapse. Dis Colon Rectum. 2005;48(9):1800–1.

    Article  PubMed  Google Scholar 

  9. Ruurda JP, Visser PL, Broeders IA. Analysis of procedure time in robot-assisted surgery: comparative study in laparoscopic cholecystectomy. Comput Aided Surg. 2003;8(1):24–9.

    Article  PubMed  Google Scholar 

  10. Heemskerk J, Zandbergen R, Maessen JG, Greve JW, Bouvy ND. Advantages of advanced laparoscopic systems. Surg Endosc. 2006;20(5):730–3.

    Article  CAS  PubMed  Google Scholar 

  11. Ayav A, Bresler L, Hubert J, Brunaud L, Boissel P. Robotic-assisted pelvic organ prolapse surgery. Surg Endosc. 2005;19(9):1200–3.

    Article  CAS  PubMed  Google Scholar 

  12. Munz Y, Moorthy K, Kudchadkar R, et al. Robotic assisted rectopexy. Am J Surg. 2004;187(1):88–92.

    Article  PubMed  Google Scholar 

  13. Mäkelä-Kaikkonen J, Rautio T, Klintrup K, et al. Robotic-assisted and laparoscopic ventral rectopexy in the treatment of rectal prolapse: a matched-pairs study of operative details and complications. Tech Coloproctol. 2014;18(2):151–5.

    Article  PubMed  Google Scholar 

  14. Heemskerk J, de Hoog DE, van Gemert WG, Baeten CG, Greve JW, Bouvy ND. Robot-assisted vs. conventional laparoscopic rectopexy for rectal prolapse: a comparative study on costs and time. Dis Colon Rectum. 2007;50(11):1825–30.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Germain A, Perrenot C, Scherrer ML, et al. Long-term outcome of robotic-assisted laparoscopic rectopexy for full-thickness rectal prolapse in elderly patients. Colorectal Dis. 2014;16(3):198–202.

    Article  CAS  PubMed  Google Scholar 

  16. de Hoog DE, Heemskerk J, Nieman FH, van Gemert WG, Baeten CG, Bouvy ND. Recurrence and functional results after open versus conventional laparoscopic versus robot-assisted laparoscopic rectopexy for rectal prolapse: a case-control study. Int J Colorectal Dis. 2009;24(10):1201–6.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Perrenot C, Germain A, Scherrer ML, Ayav A, Brunaud L, Bresler L. Long-term outcomes of robot-assisted laparoscopic rectopexy for rectal prolapse. Dis Colon Rectum. 2013;56(7):909–14.

    Article  PubMed  Google Scholar 

  18. Haahr C, Jakobsen HL, Gögenur I. Robot-assisted rectopexy is a safe and feasible option for treatment of rectal prolapse. Dan Med J. 2014;61(5):A4842.

    PubMed  Google Scholar 

  19. Orr TG. A suspension operation for prolapse of the rectum. Ann Surg. 1947;126(5):833–7.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Loygue J, Nordlinger B, Cunci O, Malafosse M, Huguet C, Parc R. Rectopexy to the promontory for the treatment of rectal prolapse. Report of 257 cases. Dis Colon Rectum. 1984;27(6):356–9.

    Article  CAS  PubMed  Google Scholar 

  21. Loygue J, Cerbonnet G. Surgical treatment of total prolapse of the rectum by rectopexy following the Orr technic; based on 14 case reports. Mem Acad Chir (Paris). 1957;83(10–11):325–9.

    CAS  PubMed  Google Scholar 

  22. Loygue J, Huguier M, Malafosse M, Biotois H. Complete prolapse of the rectum. A report on 140 cases treated by rectopexy. Br J Surg. 1971;58(11):847–8.

    Article  CAS  PubMed  Google Scholar 

  23. Nelson R, Spitz J, Pearl RK, Abcarian H. What role does full rectal mobilization alone play in the treatment of rectal prolapse? Tech Coloproctol. 2001;5(1):33–5.

    Article  CAS  PubMed  Google Scholar 

  24. Tou S, Brown SR, Malik AI, Nelson RL. Surgery for complete rectal prolapse in adults. Cochrane Database Syst Rev. 2008;4, CD001758.

    Google Scholar 

  25. Portier G, Iovino F, Lazorthes F. Surgery for rectal prolapse: Orr-Loygue ventral rectopexy with limited dissection prevents postoperative-induced constipation without increasing recurrence. Dis Colon Rectum. 2006;49(8):1136–40.

    Article  PubMed  Google Scholar 

  26. D’Hoore A, Cadoni R, Penninckx F. Long-term outcome of laparoscopic ventral rectopexy for total rectal prolapse. Br J Surg. 2004;91(11):1500–5.

    Article  PubMed  Google Scholar 

  27. D’Hoore A, Penninckx F. Laparoscopic ventral recto(colpo)pexy for rectal prolapse: surgical technique and outcome for 109 patients. Surg Endosc. 2006;20(12):1919–23.

    Article  PubMed  Google Scholar 

  28. Madiba TE, Baig MK, Wexner SD. Surgical management of rectal prolapse. Arch Surg. 2005;140(1):63–73.

    Article  PubMed  Google Scholar 

  29. Zbar AP, Madoff RD, Wexner SD. Reconstructive surgery of the rectum, anus and perineum. 2013. http://dx.doi.org/10.1007/978-1-84882-413-3.

    Book  Google Scholar 

  30. Bowers S, Hunter J. Contraindications to laparoscopy. In: Whelan R, Fleshman Jr J, Fowler D, editors. The Sages Manual. New York: Springer; 2006. p. 25–32.

    Chapter  Google Scholar 

  31. Srivastava A, Niranjan A. Secrets of safe laparoscopic surgery: anaesthetic and surgical considerations. J Min Access Surg. 2010;6(4):91–4.

    Article  Google Scholar 

  32. Brown SR, Hartley JE, Hill J, Scott N, Williams JG. Contemporary coloproctology. 2012. http://dx.doi.org/10.1007/978-0-85729-889-8.

    Book  Google Scholar 

  33. Altomare DF, Pucciani F. Rectal prolapse: diagnosis and clinical management. New York: Springer; 2008.

    Book  Google Scholar 

  34. Kunitake H. Corman’s colon and rectal surgery, Sixth Edition. Ann Surg. 2014;259(5):1035.

    Article  Google Scholar 

  35. Lieberth M, Kondylis LA, Reilly JC, Kondylis PD. The Delorme repair for full-thickness rectal prolapse: a retrospective review. Am J Surg. 2009;197(3):418–23.

    Article  PubMed  Google Scholar 

  36. Mathew MJ, Parmar AK, Reddy PK. Mesh erosion after laparoscopic posterior rectopexy: a rare complication. J Min Access Surg. 2014;10(1):40–1.

    Article  Google Scholar 

  37. Novell JR, Osborne MJ, Winslet MC, Lewis AA. Prospective randomized trial of Ivalon sponge versus sutured rectopexy for full-thickness rectal prolapse. Br J Surg. 1994;81(6):904–6.

    Article  CAS  PubMed  Google Scholar 

  38. Athanasiadis S, Weyand G, Heiligers J, Heumuller L, Barthelmes L. The risk of infection of three synthetic materials used in rectopexy with or without colonic resection for rectal prolapse. Int J Colorectal Dis. 1996;11(1):42–4.

    Article  CAS  PubMed  Google Scholar 

  39. Faucheron JL, Voirin D, Riboud R, Waroquet PA, Noel J. Laparoscopic anterior rectopexy to the promontory for full-thickness rectal prolapse in 175 consecutive patients: short- and long-term follow-up. Dis Colon Rectum. 2012;55(6):660–5.

    Article  PubMed  Google Scholar 

  40. Boons P, Collinson R, Cunningham C, Lindsey I. Laparoscopic ventral rectopexy for external rectal prolapse improves constipation and avoids de novo constipation. Colorectal Dis. 2010;12(6):526–32.

    Article  CAS  PubMed  Google Scholar 

  41. Collinson R, Wijffels N, Cunningham C, Lindsey I. Laparoscopic ventral rectopexy for internal rectal prolapse: short-term functional results. Colorectal Dis. 2010;12(2):97–104.

    Article  CAS  PubMed  Google Scholar 

  42. Smart NJ, Pathak S, Boorman P, Daniels IR. Synthetic or biological mesh use in laparoscopic ventral mesh rectopexy—a systematic review. Colorectal Dis. 2013;15(6):650–4.

    Article  CAS  PubMed  Google Scholar 

  43. Hernández P, Targarona EM, Balagué C, et al. Laparoscopic treatment of rectal prolapse. Cir Esp. 2008;84(6):318–22.

    Article  PubMed  Google Scholar 

  44. Badrek-Al Amoudi AH, Greenslade GL, Dixon AR. How to deal with complications after laparoscopic ventral mesh rectopexy: lessons learnt from a tertiary referral centre. Colorectal Dis. 2013;15(6):707–12.

    Article  CAS  PubMed  Google Scholar 

  45. Williams NS, Giordano P, Dvorkin LS, Huang A, Hetzer FH, Scott SM. External pelvic rectal suspension (the Express procedure) for full-thickness rectal prolapse: evolution of a new technique. Dis Colon Rectum. 2005;48(2):307–16.

    Article  CAS  PubMed  Google Scholar 

  46. Smart NJ, Mercer-Jones MA. Functional outcome after transperineal rectocele repair with porcine dermal collagen implant. Dis Colon Rectum. 2007;50(9):1422–7.

    Article  PubMed  Google Scholar 

  47. Meschia M, Pifarotti P, Bernasconi F, Magatti F, Riva D, Kocjancic E. Porcine skin collagen implants to prevent anterior vaginal wall prolapse recurrence: a multicenter, randomized study. J Urol. 2007;177(1):192–5.

    Article  PubMed  Google Scholar 

  48. Tjandra JJ, Fazio VW, Church JM, Milsom JW, Oakley JR, Lavery IC. Ripstein procedure is an effective treatment for rectal prolapse without constipation. Dis Colon Rectum. 1993;36(5):501–7.

    Article  CAS  PubMed  Google Scholar 

  49. McKee RF, Lauder JC, Poon FW, Aitchison MA, Finlay IG. A prospective randomized study of abdominal rectopexy with and without sigmoidectomy in rectal prolapse. Surg Gynecol Obstet. 1992;174(2):145–8.

    CAS  PubMed  Google Scholar 

  50. Mollen RM, Kuijpers JH, van Hoek F. Effects of rectal mobilization and lateral ligaments division on colonic and anorectal function. Dis Colon Rectum. 2000;43(9):1283–7.

    Article  CAS  PubMed  Google Scholar 

  51. Samaranayake CB, Luo C, Plank AW, Merrie AE, Plank LD, Bissett IP. Systematic review on ventral rectopexy for rectal prolapse and intussusception. Colorectal Dis. 2010;12(6):504–12.

    Article  CAS  PubMed  Google Scholar 

  52. Snooks SJ, Henry MM, Swash M. Anorectal incontinence and rectal prolapse: differential assessment of the innervation to puborectalis and external anal sphincter muscles. Gut. 1985;26(5):470–6.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  53. Ashari LH, Lumley JW, Stevenson AR, Stitz RW. Laparoscopically-assisted resection rectopexy for rectal prolapse: ten years’ experience. Dis Colon Rectum. 2005;48(5):982–7.

    Article  PubMed  Google Scholar 

  54. Ripstein CB. Treatment of massive rectal prolapse. Am J Surg. 1952;83(1):68–71.

    Article  CAS  PubMed  Google Scholar 

  55. Reconstructive surgery of the rectum, anus and perineum. New York: Springer; 2012.

    Google Scholar 

  56. Steele SR, Goetz LH, Minami S, Madoff RD, Mellgren AF, Parker SC. Management of recurrent rectal prolapse: surgical approach influences outcome. Dis Colon Rectum. 2006;49(4):440–5.

    Article  PubMed  Google Scholar 

  57. Tsugawa K, Sue K, Koyanagi N, et al. Laparoscopic rectopexy for recurrent rectal prolapse: a safe and simple procedure without a mesh prosthesis. Hepatogastroenterology. 2002;49(48):1549–51.

    PubMed  Google Scholar 

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Correspondence to Joseph C. Carmichael M.D. .

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Carmichael, J.C., Moghadamyeghaneh, Z. (2018). Minimally Invasive Surgery for Rectal Prolapse: Robotic Procedures. In: Pigazzi, A. (eds) Techniques in Minimally Invasive Rectal Surgery. Springer, Cham. https://doi.org/10.1007/978-3-319-16381-9_13

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  • DOI: https://doi.org/10.1007/978-3-319-16381-9_13

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