Publication details
Robotic vs. Conventional Laparoscopic Rectopexy for Rectal Prolapse. A Single Center Experience.
| Title in English | Robotic vs. Conventional Laparoscopic Rectopexy for Rectal Prolapse. A Single Center Experience |
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| Authors | |
| Year of publication | 2011 |
| Type | Conference abstract |
| MU Faculty or unit | |
| Citation | |
| Description | Supported byGrant IGA MZ ČR NS 10249-3/2009 Background. The aim of this study was to compare the traditional laparoscopic approach and robotic techniques in the treatment complete rectal prolaps. Laparoscopic rectopexy has become one of the most advocated treatments for full-thickness rectal prolapse, offering good functional results compared with open surgery and resulting in less postoperative pain and faster convalescence. However, laparoscopic rectopexy can be technically demanding. Once having mastered dexterity, with robotic assistance, laparoscopic rectopexy can be performed faster. This may lead to faster and safer laparoscopic surgery. Methods:During 5-years pediod, from 101 consecutive robotic colorectal cases 48 patients with complete rectal prolaps were operated using the da Vinci robotic system and from 107 consecutive laparoscopic colorectal procedures 17 patients with rectal prolaps.Clinical data were prospectively collected and analyzed. Before the operation a detailed clinical history was collected, and the patients were studied by inspection and digital examination of the anorectum, endoscopy, pancolonic transit time, defecography, anorectal manometry and anal electromyography. After the operation all patients underwent perineal physiotherapy and perineal biofeedback Results:Mean operative time was 190 min/range 140- 240/ incl. setup time in robotic group and 240 min/range 210-280/ in laparoscopic group.There were no mortality and no specific morbidity due to the robotic aproach. There were 80% patients under 7 days hospital stay in robotic group and 65% in laparoscopic group.After period of 6 month, all patients were free of rectal prolapse and they were satisfied with anatomical and functional results.In these patiens the functional results improved significantly after the operation. The basal pressure of the anal sphincter, squeezing pressure, rectoanal reflex, anal – perianal pain and evacuation dysorders improved significantly. Conclusion:Our experience indicates that using robotic system da Vinci is faesible, safe, and effective in the treatment of complet rectal prolaps and pelvic floor dysfunction syndrome. Transabdominal surgery for complete rectal prolapse between anothers performances (transperineal, transanal) seems to be most comprehensive, with adequate functional results, and one of the main indication of the use of da Vinci robotic system in colorectal surgery resolving this area. |
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