Robotic Rectopexy for Pediatric Rectal Prolapse: Implementation, Technique, and Outcomes from a Single Institution

A robotic approach to rectopexy for rectal prolapse improves ease of lower pelvic dissection, visualization, and ergonomics for the surgeon. We present our experience with implementation, technique, and outcomes of robotic rectopexy for children with rectal prolapse.

A retrospective review of patients who underwent robotic rectopexy from May 2019 to January 2026 at our institution was performed.

Eleven cases of rectal prolapse were included with 10 (90.9%) patients who had chronic constipation. The median age was 15.8 years (11.1, 17.5) and weight was 45.0 kg (38.1, 49.6). Four patients (36.4%) had previous abdominal surgery. Preoperatively, 5 patients (45.5%) required manual reduction of prolapse, 11 patients (100%) trialed stool softeners, 6 (54.5%) underwent pelvic floor physical therapy, and 7 (63.6%) had previous sclerotherapy. The median operative time was 235.0 minutes (201.5, 305.0). The median hospital length of stay was 3.0 days (1.5, 3.5) with no complications or deaths at 30 days. All patients demonstrated resolution over median 2.0 months (0.9, 13.7) of follow up.

The use of the robotic platform in pediatric rectopexy for rectal prolapse is feasible and safe with high rates of resolution in the short term.