Current status of laparoscopic and robotic ventral mesh rectopexy for external and internal rectal prolapse

Table 1 Conversion, intra- and postoperative complications following laparoscopic and robotic ventral mesh rectopexy with synthetic mesh n (%)

	n	Median FU (mo)	Intra-operative complications	Conversion	Postoperative complications
					Total	Minor (CD 1-2)	Major (CD 3-4)	Mortality (CD 5)
Laparoscopic studies
D'Hoore et al[6], 2004	42	61	0	2 (4.8)	2 (4.8)	2 (4.8)	0	0
D'Hoore et al[84], 2006	109	-	0	4 (3.7)	8 (7.3)	8 (7.3)	0	0
Slawik et al[62], 2008	80	54	-	1 (1.3)	7 (8.8)	7 (8.8)	0	0
van den Esschert et al[54], 2008	17	381	0	1 (5.9)	4 (23.5)	3 (17.6)	1 (5.9)	0
Boons et al[44], 2010	65	19	-	1 (1.5)	11 (16.9)	6 (9.2)	5 (7.7)	0
Collinson et al[51], 2010	75	12	0	1 (1.3)	4 (5.3)	3 (4)	0	0
Wijffels et al[85], 2011	80	23	-	1 (1.3)	10 (12.5)	9 (11.3)	1 (1.3)	0
Wong et al[36], 2011	40	6	0	4 (10.0)	5 (12.5)	5 (12.5)	0	0
Wong et al[52], 2011	84	29	4 (4.8)	3 (3.6)	3 (3.6)	2 (2.4)	1 (1.2)	0
Lauretta et al[24], 2012	30	13.91	-	0	2 (7.7)	0	2 (7.7)	0
Faucheron et al[86], 2012	175	74/602	0	3 (1.7)	8 (4.6)	5 (2.9)	3 (1.7)	0
Formijne Jonkers et al[23], 2013	233	30	0	6 (2.6)	11 (4.7)	7 (3.0)	4 (1.7)	0
Badrek-Amoudi et al[25], 2013	48	33	-	0	9 (18.8)	8 (16.7)	1 (2.1)	0
Maggiori et al[26], 2013	33	421	0	1 (3.0)	0	0	0	0
Mantoo et al[38], 2013	74	16	0	3 (4.1)	15 (20.0)	15 (20.0)	0	0
Mäkelä-Kaikkonen et al[37], 20143	20	3	0	0	1 (5.0)	0	1 (5.0)	0
Mackenzie et al[32], 2014	953	21	-	8 (1.3)	63 (6.6)	53 (5.6)	8 (0.8)	2 (0.2)
Ogilvie et al[30], 2014	29	15.4	1 (3.4)	0	3 (10.3)	2 (6.9)	1 (3.4)	0
Randall et al[31], 2014	190	29	1 (0.5)	5 (2.6)	22 (11.6)	11 (5.7)	8 (4.2)	2 (1.1)
Owais et al[53], 2014	68	42	0	0	11 (16.2)	10 (14.7)	1 (1.5)	0
Gosselink et al[29], 2015	91	12	0	0	5 (5)	4 (4.4)	0	0
Tsunoda et al[33], 2015	26	16	0	0	2 (7.7)	2 (7.7)	0	0
Consten/van Iersel et al[12], 2015	919	33.9/1202	3 (0.3)	20 (2.2)	203 (23.4)	153 (19.3)	50 (4.1)	1 (0.1)
Tsunoda et al[34], 2016	31	25	0	0	2 (6.5)	2 (6.5)	0	0
Robotic studies
Wong et al[36], 2011	23	6	0	1 (4.3)	1 (4.3)	0	0	0
Mantoo et al[38], 2013	74	164	0	1 (2.3)	5 (11.0)	5 (11.0)	0	0
Mäkelä-Kaikkonen et al[37], 20143	20	3	1 (5.0)	0	1 (5.0)	1 (5.0)	0	0

¹Mean instead of median;

²Percentages are Kaplan-Meier estimates at 60 and 120 mo of follow-up;

³The results of Wong, Mantoo and Mäkelä-Kaikkonen et al are displayed per technique;

⁴Not specified whether mean of median was used. FU: Follow-up; - : Not specified or not applicable.

Table 2 Functional results following laparoscopic and robotic ventral mesh rectopexy with synthetic mesh

Laparoscopic studies	n	Median FU (mo)	Improvement OD	P value	Improvement FI	P value	Median gain CCCS	P value	Median gain CCIS	P value
Indication ERP
D’Hoore et al[6], 2004	42	61	84.2%. De novo 4.8%	-	90.3%	-	-	-	13	< 0.001
Auguste et al[21], 2006	54	12	70%. De novo 17.6%		72.4%		-	-	5.81	-
Verdaasdonk et al[42], 20062	13	7	66%	-	69%	-	-	-	-	-
Cristaldi et al[43], 2007	63	18	78%	-	90%. De novo 3.2%	-	5	< 0.0001	32 (FISI)	< 0.0001
Boons et al[44], 2010	583	19	72%	-	83%. De novo 1.5%	-	5	< 0.0001	36 (FISI)	< 0.0001
Formijne Jonkers et al[23], 20134	36	30	57.9%	0.01	76.2%	< 0.001	-	-	-	-
Randall et al[31], 2014	190	29	-	-	93%	-	-	-	8	< 0.0001
Gosselink et al[29], 20154	41	12	-	-	50%	< 0.01	4.8	< 0.01	12 (FISI)	< 0.01
Tsunoda et al[33], 201545	19	12	52%	-	62%	-	7	< 0.0001	23 (FISI)	< 0.0001
Consten/van Iersel et al[12], 20154	242	33.9	63.3%	< 0.0001	73.2%	< 0.0001	-	-	-	-
Tsunoda et al[34], 2016	31	12	-	-	-	-	5	0.005	22 (FISI)	< 0.0001
Indication IRP and/or rectocele
Collinson et al[50], 2007	30	3	83%	-	92%	-	9	< 0.0001	25 (FISI)	< 0.0001
Collinson et al[51], 2010	75	12	86%	-	85%	-	7	< 0.0001	20 (FISI)	< 0.0001
Wong et al[52], 2011	84	29	45%	< 0.001	20%	> 0.05	-	-	-	-
Formijne Jonkers et al[23], 20134	197	30	76.9%	< 0.001	65.4%	< 0.001	-	-	-	-
Gosselink et al[28], 2013	72	12	-	-	-	-	5	< 0.001	16 (FISI)	< 0.01
Gosselink et al[29], 20154	50	12	-	-	48%	< 0.01	3.1	< 0.01	17 (FISI)	< 0.01
Tsunoda et al[33], 201545	25	12	55%	-	63%	-	6	< 0.0001	22 (FISI)	< 0.0001
Tsunoda et al[87], 2015	26	16	-	-	-	-	7	< 0.01	24 (FISI)	< 0.01
Consten/van Iersel et al[12], 20154	242	33.9	61%	< 0.0001	73.2%	< 0.0001	-	-	-	-
Indication both ERP and IRP and/or rectocele
van den Esschert et al[54], 2008	1 ERP, 16 IRP	381	-	-	-	-	+2.76 (ODS)	0.091	-	-
Lauretta et al[24], 2012	2 ERP, 28 IRP	13.91	92.8%	-	85.7%	-	9.1 (ODS)1[88]	< 0.05	7.11	< 0.05
Badrek-Amoudi et al[25], 2013	11 ERP, 37 IRP	33	68%	< 0.0001	-	-	17 (ODS)7[89]	< 0.0001	4	< 0.0001
Maggiori et al[26], 2013	338	421	72%. De novo 7%	-	90%	-	-	-	8	0.002
Mackenzie et al[32], 2014	149 ERP, 487 IRP	21	56.7%9. De novo 1.4%	0.119	89.7%10. De novo 1%	0.040	12 (ODS )[88]	-	8	-
Owais et al[53], 201411	18 ERP, 50 IRP	42	82%	-	82%	-	12.5 (ODS)[90]	< 0.001	4	< 0.001
Robotic vs Laparoscopic studies - various indications
De Hoog et al[39], 20091	20 ERP R	23.4	-	-	-	-	3.21	-	-	-
Mantoo et al[38], 201312	23 ERP, 51 IRP L	1613	-	-	-	-	6 (ODS)14	0.004	414	0.604
	12 ERP, 32 IRP R						14 (ODS)14[91]	0.004	414	0.604

¹Mean instead of median;

²One patient was excluded from further analysis, therefore n = 13 instead of n = 14 was used;

³Functional data were complete in 58 of 65 patients;

⁴The results of Formijne Jonkers et al, Gosselink et al, Tsunoda and Consten and van Iersel et al are displayed per indication;

⁵Postoperative functional data were fulfilled in 44 of 59 patients;

⁶Mean ODS score was 2.7 higher after surgery meaning function deteriorated postoperatively; ⁷Pre- and postoperative ODS scores were available for 36 patients;

⁸Of the 33 patients (ERP n = 20, n = 13 IRR) 3 lost to follow-up. For the remainder of patients the surgical indication was not given;

⁹Based on 602 patients;

¹⁰Based on 276 patients;

¹¹Only men included;

¹²A modified version of the D’Hoore rectopexy used;

¹³Not specified whether mean of median was used;

¹⁴Estimation based on bar chart. OD: Obstructed defecation; FI: Faecal incontinence; ODS: Obstructed defecation syndrome score; L: Laparoscopic; R: Robot; RP: Internal rectal prolapse; ERP: External rectal prolapse; CCCS: Cleveland clinic constipation score; CCIS: Cleveland clinic incontinence score.

Table 3 Recurrence rates following laparoscopic and robotic ventral mesh rectopexy with synthetic mesh n (%)

Laparoscopic studies	n	FU (median)	Recurrence	Type of recurrence	Presentation of recurrence (mo)
Indication ERP
D’Hoore et al[6], 2004	42	61	2 (4.8)	2 ERP	54, 91
Verdaasdonk et al[42], 20061	13	7	2 (15.4)	2 ERP	-
Auguste et al[21], 2006	54	12	4 (7.4)	3 ERP, 1 IRP	26 (7-54)2
D’Hoore et al[84], 2006	109	-	5 (4.6)	4 ERP, 1 enterocele	-
Cristaldi et al[42], 2007	63	18	1 (1.7)	ERP	-
Boons et al[44], 2010	65	19	1 (1.5)	ERP	12
Wijffels et al[85], 2011	80	23	2 (2.5%)	2 ERP	6, 16
Faucheron et al[86], 2012	175	74/603	2 (3)3	2 ERP	6, 24
Randall et al[31], 20145	190	29	9 (4.7)	1 ERP, 8 IRP	25, 30, 31, 606
Gosselink et al[29], 20153	41	12	1 (2.3)	ERP	12
Tsunoda et al[34], 2016	31	25	3 (9.7)	3 IRP	10, 17, 31
Indication IRP and/or rectocele
Collinson et al[51], 2010	75	12	4 (5.3)	4 IRP	-
Wong et al[52], 2011	84	29	6 (7.1)	6 rectocele	-
Gosselink et al[29], 20154	50	12	3 (5.8)	3 IRP	-
Indication both ERP and IRP and/or rectocele
Lauretta et al[24], 2012	2 ERP, 28 IRP	13.97	1 (3.3)	1 IRP	19
Formijne Jonkers et al[23], 2013	36 ERP, 197 IRP	30	6 (2.6)	-	-
Badrek-Amoudi et al[25], 2013	11 ERP, 37 IRP	33	4 (8.3)	4 IRP	22 (median)
Maggiori et al[26], 2013	338	427	2 (6.7)	2 rectocele	11, 14
Mackenzie et al[32], 2014	149 ERP, 487 IRP	21	60 (9.4)	-	-
Owais et al[53], 20149	18 ERP, 60 IRP	42	2 (2.9)	2 IRP	-
Consten/van Iersel et al[12], 2015	242 ERP, 677 IRP	33.9/1203	68 (14.3)3	15 ERP, 53 IRP	24.1 (1-139.4)2
Tsunoda et al[33], 2015	19 ERP, 25 IRP	26	2 (3.4)	2 IRP	10, 15
Robotic vs Laparoscopic - various indications
De Hoog et al[39], 2009	20 ERP robot	23.4	4 (20)	-	-
Wong et al[92], 2011	23 IRP lap	12	1 (4.3)	Rectocele	3
	15 IRP robot		1 (6.7)	Rectocele	7
Wong et al[36], 2011	40 IRP lap	6	0 (0)	-	-
	23 IRP robot		0 (0)	-	-
Mantoo et al[38], 201310	23 ERP, 51 IRP lap	1611	6 (8)	-	-
	12 ERP, 32 IRP robot		3 (7)	-	-
Mäkelä-Kaikkonen et al[37], 2014	14 ERP, 6 IRP lap	3	1 (5)	-	-
	13 ERP, 7 IRP robot		0 (0)	-	-

¹One patient was excluded from further analysis, therefore n = 13 instead of n = 14 is used;

²Mean (range);

³Recurrence percentage is KM estimate at 60 and 120 mo of follow-up;

⁴The results of Gosselink et al are displayed per indication;

⁵Study group included the first 44 cases from Slawik et al[62];

⁶Only 4 time intervals are described;

⁷Mean instead of median;

⁸Of the 33 patients (ERP n = 20, n = 13 IRR) 3 lost to follow-up. For the remainder of patients the surgical indication was not given;

⁹Only men included;

¹⁰A modified version of the D’Hoore rectopexy used;

¹¹Not specified whether mean of median was used. Lap: Laparoscopic; IRP: Internal rectal prolapse; ERP: External rectal prolapse.