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World J Surg Proced. Mar 28, 2015; 5(1): 99-105
Published online Mar 28, 2015. doi: 10.5412/wjsp.v5.i1.99
Surgical management of rectal prolapse: The role of robotic surgery
Zhobin Moghadamyeghaneh, Mark H Hanna, Grace Hwang, Joseph C Carmichael, Steven D Mills, Alessio Pigazzi, Michael J Stamos
Zhobin Moghadamyeghaneh, Mark H Hanna, Grace Hwang, Joseph C Carmichael, Steven D Mills, Alessio Pigazzi, Michael J Stamos, Department of Surgery, University of California, Irvine, School of Medicine, Orange, CA 92868, United States
Author contributions: Moghadamyeghaneh Z, Hanna MH, Hwang G, Carmichael JC, Mills SD, Pigazzi A and Stamos MJ contributed to this paper.
Conflict-of-interest: We wish to confirm that there are no known conflicts of interest associated with this publication and there has been no significant financial support for this work that could have influenced its outcome.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Michael J Stamos, MD, Professor and John E Connolly Chair in Surgery, Department of Surgery, University of California, Irvine, School of Medicine, 333 City Blvd. West Suite 1600, Orange, CA 92868, United States. mstamos@uci.edu
Telephone: +1-714-4566262 Fax: +1-714-4566377
Received: September 28, 2014
Peer-review started: September 29, 2014
First decision: November 19, 2014
Revised: November 25, 2014
Accepted: December 16, 2014
Article in press: December 17, 2014
Published online: March 28, 2015
Abstract

The robotic technique as a safe approach in treatment of rectal prolapse has been widely reported during the last decade. Although there is limited clinical data regarding the benefits of robotic surgery, the safety of robotic surgery in rectal prolapse treatment has been cited by several authors. Also, the robotic approach helps overcome some of the laparoscopic approach challenges with purported advantages including improved visualization, more precise dissection, easier suturing, accurate identification of anatomic structures and fewer conversions to open surgery which can facilitate the conduct of technically challenging cases. These advantages can make robotic surgery ideally suited for minimally invasive ventral rectopexy. Currently, with greater surgeon experience in robotic surgery, the length of the procedure and the recurrence rate with the robotic approach are decreasing and short term outcomes for robotic rectal prolapse seem on par with laparoscopic and open techniques in recent studies. However, the high cost of robotic procedures is still an important issue. The benefits of a robotic approach must be weighed against the higher cost. More research is needed to better understand if the increased cost is justified by an improvement in outcomes. Also, published articles comparing long term outcomes of the robotic approach with other approaches are very limited at this time and further clinical trials are indicated to affirm the role of robotic surgery in the treatment of rectal prolapse.

Keywords: Rectal prolapse, Robotic surgery

Core tip: Robotic rectopexy is a safe and feasible technique for the treatment of rectal prolapse with improved visualization and ease of suturing. The robotic approach can provide functional results and short term outcomes similar to laparoscopic surgery. However, increased operative time and higher cost are challenges. Further prospective clinical trials assessing the role of robotic surgery in the treatment of rectal prolapse are needed.