Minimally Invasive Surgery for Rectal Procidentia, Is there a Preferred Approach?

Purpose: Rectal procidentia can be repaired with multiple different minimally invasive (laparoscopic and robotic) approaches, though it is unclear if any one approach is preferred. Herein, we have systematically reviewed the literature in an attempt to clarify if one minimally invasive approach is superior to another. Methods: Utilizing Google Scholar and PubMed a systematic review of the English literature was carried out using the terms minimally invasive, laparoscopic, robotic, and rectopexy, resection rectopexy, mesh, suture, rectal procidentia, and rectal prolapse. Inclusion criteria for our study included all studies strictly evaluating minimally invasive repairs, which provided a total of 32 studies for review. Results: No significant differences were found between different minimally invasive approaches in regards to recurrence, operative time, estimated blood loss, morbidity, mortality, length of stay, or improvement in preoperative constipation and incontinence. Conclusion: To our knowledge the literature on minimally invasive repairs of rectal procidentia is sparse and inundated by heterogeneity; with no one approach having significantly better outcomes than another. Prospective randomized controlled trials comparing different minimally invasive repairs are needed.