Published online Mar 28, 2015. doi: 10.5412/wjsp.v5.i1.99
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
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.
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.