Robot-assisted or conventional laparoscoic rectopexy for rectal prolapse? Systematic review and meta-analysis

Area of Science:

• Surgical Technology
• Gastrointestinal Surgery
• Minimally Invasive Procedures

Background:

• Robotic technology offers a safe and effective alternative to standard laparoscopy in various surgical procedures.
• The specific role of robotic assistance in laparoscopic rectopexy remains undemonstrated.

Purpose of the Study:

• To systematically review and meta-analyze the available data comparing robot-assisted rectopexy (RR) with conventional laparoscopic rectopexy (LR).
• To evaluate key outcomes including recurrence rate, conversion rate, operative time, blood loss, complications, re-operation rate, and hospital stay.

Main Methods:

• A systematic literature search was conducted across major databases (MEDLINE, EMBASE, Cochrane Library, Google Scholar) up to June 2014.
• Manual searches of reference lists were performed to identify additional relevant studies.
• Data from six included studies (340 patients) were meta-analyzed.

Main Results:

• Robot-assisted rectopexy (RR) did not significantly influence rectal prolapse recurrence, conversion, or re-operation rates compared to laparoscopic rectopexy (LR).
• RR was associated with decreased intra-operative blood loss, fewer post-operative complications, and shorter hospital stays.
• Operative time for RR was longer than LR; functional outcomes and costs could not be meta-analyzed due to data heterogeneity.

Conclusions:

• Robot-assisted rectopexy (RR) may offer limited improvements in certain post-operative outcomes compared to laparoscopic rectopexy (LR).
• Randomized controlled trials (RCTs) are necessary to compare RR and LR regarding short-term and long-term outcomes, particularly functional results and cost-effectiveness.