title: Day case robotic ventral rectopexy compared with day case laparoscopic ventral rectopexy: a prospective study.
abstract: BACKGROUND
  Ventral rectopexy to the promontory has become one of the most strongly advocated surgical treatments for patients with full-thickness rectal prolapse and deep enterocele. Despite its challenges, laparoscopic ventral rectopexy with or without robotic assistance for selected patients can be performed with relatively minimal patient trauma thus creating the potential for same-day discharge. The aim of this prospective case-controlled study was to assess the feasibility, safety, and cost of day case robotic ventral rectopexy compared with routine day case laparoscopic ventral rectopexy.
  
  
  METHODS
  Between February 28, 2014 and March 3, 2015, 20 consecutive patients underwent day case laparoscopic ventral rectopexy for total rectal prolapse or deep enterocele at Michallon University Hospital, Grenoble. Patients were selected for day case surgery on the basis of motivation, favorable social circumstances, and general fitness. One out of every two patients underwent the robotic procedure (n = 10). Demographics, technical results, and costs were compared between both groups.
  
  
  RESULTS
  Patients from both groups were comparable in terms of demographics and technical results. Patients operated on with the robot had significantly less pain (p = 0.045). Robotic rectopexy was associated with longer median operative time (94 vs 52.5 min, p < 0.001) and higher costs (9088 vs 3729 euros per procedure, p < 0.001) than laparoscopic rectopexy.
  
  
  CONCLUSIONS
  Day case robotic ventral rectopexy is feasible and safe, but results in longer operative time and higher costs than classical laparoscopic ventral rectopexy for full-thickness rectal prolapse and enterocele.
authors.affiliation: Colorectal Unit, Department of Surgery, Michallon University Hospital, 38000, Grenoble, France. JLFaucheron@chu-grenoble.fr.|University Grenoble Alps, UMR 5525, CNRS, TIMC-IMAG, 38000, Grenoble, France. JLFaucheron@chu-grenoble.fr.|Ambulatory Surgery, Department of Surgery, Michallon University Hospital, 38000, Grenoble, France. JLFaucheron@chu-grenoble.fr.|Colorectal Unit, Ambulatory Unit, Department of Surgery, Michallon University Hospital, CS 10 217, 38043, Grenoble Cedex, France. JLFaucheron@chu-grenoble.fr.
authors.forename: J-L
authors.initials: JL
authors.lastname: Faucheron
authors.affiliation: Colorectal Unit, Department of Surgery, Michallon University Hospital, 38000, Grenoble, France.|University Grenoble Alps, UMR 5525, CNRS, TIMC-IMAG, 38000, Grenoble, France.
authors.forename: B
authors.initials: B
authors.lastname: Trilling
authors.affiliation: Colorectal Unit, Department of Surgery, Michallon University Hospital, 38000, Grenoble, France.
authors.forename: S
authors.initials: S
authors.lastname: Barbois
authors.affiliation: Colorectal Unit, Department of Surgery, Michallon University Hospital, 38000, Grenoble, France.
authors.forename: P-Y
authors.initials: PY
authors.lastname: Sage
authors.affiliation: Colorectal Unit, Department of Surgery, Michallon University Hospital, 38000, Grenoble, France.
authors.forename: P-A
authors.initials: PA
authors.lastname: Waroquet
authors.affiliation: Colorectal Unit, Department of Surgery, Michallon University Hospital, 38000, Grenoble, France.|University Grenoble Alps, UMR 5525, CNRS, TIMC-IMAG, 38000, Grenoble, France.
authors.forename: F
authors.initials: F
authors.lastname: Reche
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000556:Ambulatory Surgical Procedures / Q000379:methods*; D016022:Case-Control Studies; D013505:Digestive System Surgical Procedures / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D006547:Hernia; D059685:Herniorrhaphy / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D011446:Prospective Studies; D012005:Rectal Prolapse / Q000601:surgery*; D012007:Rectum / Q000601:surgery; D065287:Robotic Surgical Procedures / Q000379:methods*; D016896:Treatment Outcome; D055815:Young Adult
keywords: Day case surgery; Laparoscopy; Minimally invasive surgery; Rectal prolapse; Rectopexy; Robotic surgery