Int J Med Robot - Early experience with robotic rectopexy.

Tópicos

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Resumo

CKGROUND: The introduction of robotics in colorectal surgery has been gaining increasing acceptance. However, experience remains still limited for pelvic floor disorders. We report herein our first cases of fully robotic rectopexy and promontofixation for rectal prolapse.METHODS: From October 2011 to June 2012, five female patients underwent a robotic rectopexy at our institution. The patients were selected according to their primary pathology and their medical history for this preliminary experience. Four of them presented a rectal prolapse associated or not with a vaginal prolapse and the last patient presented a recurrent rectal prolapse 5 years after a laparoscopic repair. The study was approved by our local ethics committee. The robot da Vinci Si (Intuitive Surgical Inc, Sunnyvale, CA) was used with a 4-port setting in all cases.RESULTS: The mean operative time was 170 minutes (range: 120-270). There was no conversion. The blood loss was minimal. One patient presented a retrorectal hematoma, treated conservatively with success. There was no other complication. The mean hospital stay was 3.6 days (range: 2-7). At 2 months, there was neither recurrence nor readmission. In comparison with the laparoscopic approach, there were no statistically significant differences.CONCLUSIONS: Robotic rectopexy and promontofixation are feasible and safe. The outcomes are encouraging, but functional results and long-term outcomes are required to evaluate the exact role of robotics for rectal prolapse.

Resumo Limpo

ckground introduct robot colorect surgeri gain increas accept howev experi remain still limit pelvic floor disord report herein first case fulli robot rectopexi promontofix rectal prolapsemethod octob june five femal patient underw robot rectopexi institut patient select accord primari patholog medic histori preliminari experi four present rectal prolaps associ vagin prolaps last patient present recurr rectal prolaps year laparoscop repair studi approv local ethic committe robot da vinci si intuit surgic inc sunnyval ca use port set casesresult mean oper time minut rang convers blood loss minim one patient present retrorect hematoma treat conserv success complic mean hospit stay day rang month neither recurr readmiss comparison laparoscop approach statist signific differencesconclus robot rectopexi promontofix feasibl safe outcom encourag function result longterm outcom requir evalu exact role robot rectal prolaps

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