title: Robotic-assisted and laparoscopic ventral rectopexy in the treatment of rectal prolapse: a matched-pairs study of operative details and complications.
abstract: BACKGROUND
  Laparoscopic ventral rectopexy has been proven to be safe and effective in the treatment of rectal prolapse or intussusception. Robotic-assisted surgery may offer potential benefits to this operation. This study describes the comparison of robotic-assisted and conventional laparoscopic ventral rectopexy in terms of clinical parameters, operative details, postoperative complications and short-term outcomes.
  
  
  METHODS
  Twenty patients operated on for rectal prolapse or intussusception using the Da Vinci Surgical System (Intuitive Surgical Inc, Sunnyvale CA, USA) were prospectively followed for 3 months. The cases were pair-matched with laparoscopically operated controls from registry files.
  
  
  RESULTS
  Mean operating time was 159 min (standard deviation; ±37 SD) and 153 min (±33 SD) and mean total time in the operating theatre 231 min (±39 SD) and 234 min (±41 SD) for robotic-assisted and laparoscopic operations, respectively. Mean blood loss was 25 ml (±49 SD) in robotic-assisted and 37 ml (±50 SD) in laparoscopic procedures. There was one (5 %) significant complication in each group. Mean length of hospital stay was 3.1 (±2 SD) and 3.3 (±1.3 SD) days for the robotic-assisted and laparoscopic groups, respectively. The subjective benefit rate was the same in both groups: 16/20 (80 %). One patient in the robotic-assisted group continued to have symptoms of obstructed defecation, and there was one recurrence of prolapse in the laparoscopic group.
  
  
  CONCLUSIONS
  Robotic-assisted laparoscopic ventral rectopexy is safe, feasible and not more time consuming than the laparoscopic technique even at the beginning of the learning curve. The short-term results are comparable with those of laparoscopy. We found no arguments to support the routine use of robotic assistance in rectopexy operations.
authors.affiliation: Division of Gastroenterology, Department of Surgery, University Hospital of Oulu, Oulu, Finland, jomakela@paju.oulu.fi.
authors.forename: J
authors.initials: J
authors.lastname: Mäkelä-Kaikkonen
authors.forename: T
authors.initials: T
authors.lastname: Rautio
authors.forename: K
authors.initials: K
authors.lastname: Klintrup
authors.forename: H
authors.initials: H
authors.lastname: Takala
authors.forename: M
authors.initials: M
authors.lastname: Vierimaa
authors.forename: P
authors.initials: P
authors.lastname: Ohtonen
authors.forename: J
authors.initials: J
authors.lastname: Mäkelä
mesh_terms: D000328:Adult; D000368:Aged; D016063:Blood Loss, Surgical; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D012005:Rectal Prolapse / Q000601:surgery*; D012008:Recurrence; D012371:Robotics