Our Summary

This research paper looks at the use of robotic surgery in treating rectal prolapse, a condition where the rectum - the end part of the large intestine - slips out of place. The study looked at the medical records of patients who had this specific type of surgery, called Robotic Ventral Mesh Rectopexy (RVMR), at their institution between 2012 and 2016. The study excluded any cases where other surgical techniques were used or part of the colon had to be removed.

Of the 24 patients they looked at, nearly all were women and most were over the age of 67. The surgery typically took just over three hours and patients usually stayed in the hospital for 3 days. There were no serious complications from the surgery, no deaths, and none of the surgeries had to be converted to a traditional non-robotic procedure.

The researchers also found that 3 patients (or 12.4%) had a recurrence of the prolapse. However, overall, symptoms improved after the surgery - fewer patients had issues with bowel control (62.5% before vs. 41.5% after) and constipation (45.8% before vs. 33.3% after). Only one patient developed new constipation issues after the procedure.

In conclusion, the study suggests that RVMR is a safe and effective treatment for rectal prolapse. It has a low risk of complications and death in the short term, but more research is needed to see how patients fare in the long term.

FAQs

  1. What is Robotic ventral mesh rectopexy (RVMR) and how is it used to treat rectal prolapse?
  2. What were the results and outcomes from the study on RVMR for rectal prolapse conducted between July 2012 and May 2016?
  3. Are there any reported complications or side effects associated with RVMR for rectal prolapse?

Doctor’s Tip

A helpful tip a doctor might tell a patient about rectal prolapse surgery is to follow postoperative care instructions carefully, including avoiding heavy lifting and strenuous activity for a period of time, taking prescribed medications as directed, and attending follow-up appointments to monitor recovery progress. It is also important to maintain good bowel habits and a healthy diet to prevent complications and promote healing.

Suitable For

Rectal prolapse surgery, including robotic ventral mesh rectopexy, is typically recommended for patients who have symptomatic rectal prolapse that significantly impacts their quality of life. Patients who have failed conservative treatments such as pelvic floor physical therapy, dietary modifications, and medications may be candidates for surgery. Additionally, patients who have associated symptoms such as fecal incontinence, constipation, and pelvic floor dysfunction may benefit from rectal prolapse surgery. It is important for patients to undergo a thorough evaluation by a colorectal surgeon to determine if surgery is the best treatment option for their specific condition.

Timeline

Before rectal prolapse surgery:

  1. Patient experiences symptoms of rectal prolapse such as feeling a bulge or protrusion from the rectum, difficulty with bowel movements, and fecal incontinence.
  2. Patient consults with a healthcare provider who recommends robotic ventral mesh rectopexy (RVMR) as a treatment option.
  3. Patient undergoes preoperative evaluations and preparation for surgery.

After rectal prolapse surgery:

  1. Patient undergoes RVMR surgery, with a median operative time of 191 minutes.
  2. Patient has a median length of stay in the hospital of 3 days.
  3. Patient is followed postoperatively for a median of 3.8 months.
  4. Patients experience improvement in symptoms of fecal incontinence and constipation after surgery.
  5. Full-thickness recurrence occurs in 12.4% of patients.
  6. There are no conversions, RVMR-related complications, or mortality reported.
  7. Only one patient reports de novo constipation postoperatively.
  8. Further studies are recommended to assess the long-term benefits of RVMR for rectal prolapse treatment.

What to Ask Your Doctor

  1. What are the potential risks and complications of robotic ventral mesh rectopexy (RVMR) for rectal prolapse?
  2. How long is the recovery process after RVMR surgery?
  3. What can I expect in terms of pain management after the procedure?
  4. Are there any dietary or lifestyle changes I should make before or after the surgery?
  5. How long do the results of RVMR typically last?
  6. Will I need any additional treatments or follow-up appointments after the surgery?
  7. Are there any long-term risks or complications associated with RVMR?
  8. How experienced are you in performing RVMR procedures?
  9. Are there any specific factors that may impact the success of RVMR in my case?
  10. Are there any alternative treatment options for rectal prolapse that I should consider?

Reference

Authors: Inaba CS, Sujatha-Bhaskar S, Koh CY, Jafari MD, Mills SD, Carmichael JC, Stamos MJ, Pigazzi A. Journal: Tech Coloproctol. 2017 Aug;21(8):667-671. doi: 10.1007/s10151-017-1675-z. Epub 2017 Sep 4. PMID: 28871416