title: Short-term outcome of laparoscopic versus robotic ventral mesh rectopexy for full-thickness rectal prolapse. Is robotic superior?
abstract: OBJECTIVE
  Short term morbidity, functional outcome, recurrence and quality of life outcomes after robotic assisted ventral mesh rectopexy (RVMR) and laparoscopic ventral mesh rectopexy (LVMR) were compared.
  
  
  METHODS
  This study includes 51 consecutive patients having operations for external rectal prolapse (ERP) in a tertiary centre between October 2009 and December 2012. Of these, 17 patients had RVMR and 34 underwent LVMR. The groups were matched for age, gender, body mass index (BMI), and American Society of Anesthesiologists (ASA) grades. The same operative technique and mesh was used and follow up was 12 months. Data was collected on patient demographics, surgery duration, blood loss, duration of hospital stay and operative complications. Functional outcomes were measured using the faecal incontinence severity index (FISI) and Wexner faecal incontinence scoring. Quality of life was scored using SF36 questionnaires pre and postoperatively.
  
  
  RESULTS
  All patients were female except three (median 59, range 25-89). There was one laparoscopic converted to open procedure. RVMR procedures were longer in duration (p = 0.013) but with no difference in blood loss between the groups. The average duration of stay was 2 days in both groups. There were six minor postoperative complications in LVMR procedures and none in the RVMR group. Pre and postoperative Wexner and FISI scoring were significantly lower in the RVMR group (p = 0.042 and p = 0.024, respectively). SF-36 questionnaires showed better scoring in physical and emotional component in RVMR group (p = 0.015). There was no recurrence in either group during follow-up.
  
  
  CONCLUSIONS
  Both LVMR and RVMR are similar in terms of safety and efficacy. Although not randomized, this data may suggest a better functional outcome and quality of life in patients having RVMR for ERP.
authors: Department of Surgery, Betsi Cadwaladr University Health Board, Ysbyty Glan Clwyd, Rhyl, North Wales, LL18 5UJ, UK, raodilmeer@yahoo.com.
authors: Rao K
authors: RK
authors: Mehmood
authors: Jody
authors: J
authors: Parker
authors: L
authors: L
authors: Bhuvimanian
authors: Eyas
authors: E
authors: Qasem
authors: Ahmed A
authors: AA
authors: Mohammed
authors: Muhammad
authors: M
authors: Zeeshan
authors: Kirsten
authors: K
authors: Grugel
authors: Paul
authors: P
authors: Carter
authors: Shakil
authors: S
authors: Ahmed
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016063:Blood Loss, Surgical; D005242:Fecal Incontinence / Q000209:etiology; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D011788:Quality of Life; D012005:Rectal Prolapse / Q000150:complications / Q000601:surgery*; D012008:Recurrence; D012371:Robotics / Q000379:methods*; D013526:Surgical Mesh; D016896:Treatment Outcome