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Robotic versus laparoscopic ventral mesh rectopexy: a systematic review and meta-analysis

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International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Introduction

Ventral mesh rectopexy is frequently performed as a means of improving the quality of life for sufferers of rectal prolapse. The minimally invasive approach is highly desirable but can be technically difficult to achieve in the narrow confines of the pelvis. The robotic platform is becoming a more common means of overcoming these difficulties, but evidence of an objective benefit over standard laparoscopy is scarce. This study seeks to review and analyse the data comparing outcomes after robotic and laparoscopic ventral mesh rectopexy.

Method

We searched MEDLINE, EMBASE and the Cochrane database for papers comparing robotic to laparoscopic ventral mesh rectopexy. Comparable data was pooled for meta-analysis.

Results

Six studies compared outcomes between robotic and laparoscopic ventral mesh rectopexy. Sample sizes were relatively small, and only two of the studies were randomised. Pooled analysis was possible for data on operating time, complication rates, conversion rates and length of stay in hospital. This showed a non-significant trend towards longer operating times and a statistically significant reduction in length of stay after robotic procedures. There was no significant difference in complication and conversion rates.

Conclusion

The frequent finding of longer operating time for robotic surgery was not confirmed in this study. Shorter length of stay in hospital was seen, with other post-operative outcomes showing no significant difference. More data is needed with cost-benefit analyses to show whether the robotic platform is justified.

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Acknowledgements

The authors gratefully acknowledge the Epworth Knowledge Services’ contribution to collating the required papers for this work.

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Author notes

  1. Julie Flynn and Jose T. Larach contributed equally to this work.

Authors and Affiliations

  1. Department of Surgery, Epworth Healthcare, Bridge Rd, Richmond, 3121, Australia

    Julie Flynn & Jose T. Larach

  2. Division of Cancer Surgery, University of Melbourne, Sir Peter MacCallum Cancer Centre, Melbourne, Australia

    Julie Flynn, Jose T. Larach, Joseph C. H. Kong, Satish K. Warrier & Alexander Heriot

  3. University of Melbourne, Sir Peter MacCallum Cancer Centre, Melbourne, Australia

    Julie Flynn, Joseph C. H. Kong, Satish K. Warrier & Alexander Heriot

  4. Departamento de Cirugía Digestiva, Pontificia Universidad Católica de Chile, Santiago, Chile

    Jose T. Larach

  5. Division of Cancer Research, University of Melbourne, Sir Peter MacCallum Cancer Centre, Melbourne, Australia

    Joseph C. H. Kong, Satish K. Warrier & Alexander Heriot

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  1. Julie Flynn
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Corresponding author

Correspondence to Julie Flynn.

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Conflict of interest

J Flynn No conflicts of interest or financial ties to disclose.

JT LarachEducational grant funded by Intuitive Surgical

J KongNo conflicts of interest or financial ties to disclose.

S Warrier Honorarium for proctoring robotic cases.

A Heriot No conflicts of interest or financial ties to disclose.

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Flynn, J., Larach, J.T., Kong, J.C.H. et al. Robotic versus laparoscopic ventral mesh rectopexy: a systematic review and meta-analysis. Int J Colorectal Dis 36, 1621–1631 (2021). https://doi.org/10.1007/s00384-021-03904-y

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  • DOI: https://doi.org/10.1007/s00384-021-03904-y

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