AB142. SOH25_AB_283. Introduction of a robotic ventral mesh rectopexy programme in a tertiary robotic centre

Background: Rectal prolapse, affecting 2.5/100,000 of the population, significantly impacts quality of life. Trans-abdominal and perineal approaches have been the mainstay of surgical management, but there are associated high recurrence rates. Robotic ventral mesh rectopexy (R-VMR) is a minimally invasive alternative, that offers improved visualisation, precise dissection and reduced morbidity. R-VMR was introduced to our unit in March 2024. This case series outlines our early experience with the technique in a high volume robotic colorectal surgery centre.

Methods: A retrospective chart review of all patients undergoing R-VMR in the first eight months of the programme was performed. Pre-operative endoscopic, radiological and clinical examination findings were collated. Pre-operative and 6-week post-operative faecal incontinence scores (FISs) were compared. Patients underwent R-VMR via a standardised approach by a single fellowship trained surgeon. The enhanced consent form available on the pelvic floor society website was utilised.

Results: A total of six women underwent R-VMR. Five patients attended via the pelvic floor clinic while one presented emergently via the emergency department. The mean age was 75 years. The mean number of vaginal delivery was 3.6. All patients had full thickness rectal prolapse. There were no intra- or post-operative complications. No patients developed recurrence of prolapse within the follow-up period. Mean relative improvement in FIS was 53%.

Conclusions: In a carefully selected cohort of patients, R-VMR can safely be implemented in a high-volume robotic surgery centre, offers an additional treatment option for rectal prolapse and has relatively lower recurrence rates compared with perineal approaches.

Keywords: Incontinence; pelvic floor surgery; rectal prolapse; robotic surgery; ventral mesh rectopexy (VMR)