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01.06.2016 | Original Article

Anatomical and functional changes to the pelvic floor after robotic versus laparoscopic ventral rectopexy: a randomised study

verfasst von: Johanna K. Mäkelä-Kaikkonen, Tero T. Rautio, Sari Koivurova, Eija Pääkkö, Pasi Ohtonen, Fausto Biancari, Jyrki T. Mäkelä

Erschienen in: International Urogynecology Journal | Ausgabe 12/2016

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Abstract

Introduction and hypothesis

To compare the effect of laparoscopic and robot-assisted ventral rectopexy for posterior compartment procidentia on the pelvic floor anatomy and function.

Methods

A prospective randomised single-centre study was carried out of 29 female patients, who underwent robot-assisted or laparoscopic ventral mesh rectopexy for external or internal rectal prolapse with symptoms of obstructive defecation and/or faecal incontinence. Anatomical changes were measured by Pelvic Organ Prolapse Quantification (POP-Q) and magnetic resonance defecography. Functional changes were evaluated using symptom questionnaires before and 3 months after surgery.

Results

After rectopexy, changes in POP-Q measurements were statistically significant for points Ap, Bp, C, D and Ba. The descent of the anorectum and cervix/vaginal cuff during straining were significantly reduced with regard to the reference line (mean, −10.4 ± 14.9 mm, p = 0.001) and (−13.3 ± 18.1 mm, p < 0.001) respectively. Pelvic organ mobility (POM) was reduced statistically significantly for the posterior (mean, −16.6 ± 20.8 mm, p < 0.001) and apical compartments (mean, −13.1 ± 14.8, p < 0.001). The PFDI-20, PFIQ-7 and PISQ-12 questionnaires showed statistically significant improvement of symptoms and sexual function. No significant differences were observed between the robot-assisted and laparoscopic techniques in terms of anatomical or functional parameters.

Conclusion

Ventral mesh recto-colpo-sacropexy effectively corrects the anatomy of the posterior compartment, elevates the vaginal apex and reduces pelvic organ mobility of the posterior and middle compartments. The robot-assisted and laparoscopic techniques had similar anatomical and functional outcomes.

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Titel: Anatomical and functional changes to the pelvic floor after robotic versus laparoscopic ventral rectopexy: a randomised study
verfasst von: Johanna K. Mäkelä-Kaikkonen
Tero T. Rautio
Sari Koivurova
Eija Pääkkö
Pasi Ohtonen
Fausto Biancari
Jyrki T. Mäkelä
Publikationsdatum: 01.06.2016
Verlag: Springer London
Erschienen in: International Urogynecology Journal / Ausgabe 12/2016
Print ISSN: 0937-3462
Elektronische ISSN: 1433-3023
DOI: https://doi.org/10.1007/s00192-016-3048-y

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Anatomical and functional changes to the pelvic floor after robotic versus laparoscopic ventral rectopexy: a randomised study