Related Experiment Video
Updated: Jun 10, 2026
Laparoscopic Non-Mesh Cerclage Pectopexy for Pelvic Organ Prolapse
Published on: September 13, 2022
Laparoscopic and robotic ventral rectopexy for posterior compartment disorders: a multicentric study in a
Giovanni Panico1, Sara Mastrovito1, Tomaso Melocchi2,3
1Department of Woman and Child's Health and Public Health, Division of Urogynecology and Reconstructive Surgery of Pelvic Floor, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.
Introduction:
This study aimed to evaluate postoperative outcomes of minimally invasive ventral rectopexy (VRP) performed for posterior compartment defects in a gynecological setting, according to laparoscopic (L-VRP) or robotic (R-VRP) approaches.
Methods:
Women with symptomatic posterior compartment defects, including enterocele, rectal prolapse, and rectocele, who underwent L-VRP or R-VRP, were retrospectively analyzed. Primary outcome was the evaluation of functional outcomes at ≥ 6-month follow-up; secondary outcomes included anatomical results, peri- and postoperative complications, and predictors of recurrence, postoperative constipation, and anal incontinence.
Results:
A total of 102 women were included, 60 in the L-VRP group and 42 in the R-VRP group. Anterior sacrocolpopexy was performed in 70.6% of women (72/102). At a mean of 18-month follow-up, anorectal symptoms rate, constipation [L-VRP (17.7 ± 5.5) versus (2.5 ± 3.6): p < 0.001; R-VRP (15.2 ± 5.4) versus (2.6 ± 4.6): p < 0.001], and incontinence [L-VRP (11.6 ± 4.6) versus (1.1 ± 3.1): p < 0.001; R-VRP (10.7 ± 5.1) versus (1.2 ± 2.2): p < 0.001] Wexner scores significantly improved without difference according to the surgical route (p > 0.05). Posterior prolapse relapse was 1.0% (1/101), without difference between groups [L-VRP (1.7%;1/60) versus R-VRP (0%;0/41); p = 0.99]. Other anatomical and functional outcomes did not significantly differ between groups. One woman in L-VRP group (1.0%; 1/101) required the resection of the mesh for infection of the implanted material. No predictive factors emerged at multivariate analysis.
Conclusions:
Minimally invasive VRP was associated with significant short- to mid-term anatomical and functional improvement and a low rate of perioperative complications. No statistically significant differences were observed between laparoscopic and robotic approaches; however, the study was not powered to demonstrate equivalence, and longer follow-up is required to assess durability and delayed mesh-related complications.
Trial Registration:
DIPUSVSP-27-07-2087 retrospectively registered.
