Transvaginal rectopexy using the Flex^® Colorectal Drive Robotic System: a proof-of-concept approach to rectal...

Area of Science:

• Surgical Innovation
• Minimally Invasive Surgery
• Pelvic Floor Disorders

Background:

• Rectal prolapse management traditionally involves transabdominal or perineal approaches with varying outcomes.
• Transabdominal rectopexy offers durability, while perineal procedures have lower morbidity.
• A combined approach is needed to achieve both durability and reduced morbidity.

Purpose of the Study:

• To demonstrate a proof-of-concept for a transvaginal sacral rectopexy.
• To utilize the Flex® Colorectal Drive Robotic System for this novel approach.
• To assess feasibility in a cadaveric model.

Main Methods:

• A fresh female cadaver underwent a transvaginal approach to develop the rectovaginal space.
• The Flex® robot was used to place mesh secured to the sacral promontory and anterior rectal wall.
• Laparotomy confirmed mesh anchoring.

Main Results:

• Successful transvaginal sacral rectopexy was performed in a cadaver.
• This marks the first use of the Flex® Colorectal Drive robot in a transvaginal procedure.
• Mesh placement and anchoring were verified.

Conclusions:

• Transvaginal rectopexy with the Flex® robot is a potential surgical option for rectal prolapse.
• This technique may offer the durability of transabdominal surgery with the lower morbidity of perineal approaches.
• Further cadaveric studies are needed before in vivo application.