Outcomes of minimally invasive approaches to rectopexy: laparoscopic versus robotic

Literature has previously compared the outcomes amongst the different approaches of operative management of rectal prolapse. There is no national dataset comparing robotic rectopexy to other approaches. This study aims to compare the outcomes of patients undergoing rectopexy with and without resection via a laparoscopic versus robotic approach. A retrospective study of the American College of Surgeons National Surgical Quality Improvement Program database (2022-2023) was performed to identify patients who underwent minimally invasive surgery for rectal prolapse. Laparoscopic versus robotic surgery for rectopexy alone and with sigmoid resection was assessed. Comparisons were made between patient demographics and comorbidities. Post-operative outcomes were evaluated. Younger patients underwent robotic rectopexy, and more females underwent robotic rectopexy with resection compared to laparoscopic. There were no significant differences in terms of race/ethnicity, comorbidities, or morbidity. There was a significantly increased mean operative time in the robotic rectopexy groups compared to laparoscopic. With rectopexy alone, there was a significantly decreased total length of stay in the robotic group. In a sub-analysis of those aged ≥ 65 years, there was a significant reduction in the total length of stay in the robotic with resection group. Robotic rectopexy with and without resection is a safe option with no significant differences in morbidity. Although the mean operative time is greater in the robotic group, there is a decreased length of stay with the robotic approach compared to laparoscopic. Future inquiry should prospectively compare outcomes of robotic rectopexy to other approaches, sub-stratified by age and sex.