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Purpose : Our experience in robotic-assisted rectopexy with sigmoid colon resection (RAR+SR) or without sigmoid colon resection (RAR) was reviewed to determine if there was a significant difference in intra-operative or postoperative outcomes.
Methods : We retrospectively reviewed 26 patients that underwent robotic-assisted rectopexy for rectal prolapse from 2006 to 2012. Rectopexy is performed with primary suture pexy and without mesh. Continuous variables were analyzed by t-test, while Fisher's exact test was applied for categorical data.
Results : Twenty-two patients underwent RAR and 4 patients underwent RAR+SR. The average age for study participants was 56 years (range 21-78 years) and consisted of 4 men and 22 women. Recurrent rectal prolapse occurred in 2 patients at 3 and 30 months after surgery in the RAR group and no recurrence occurred in the RAR+SR group (p=1.00). The duration of surgery for RAR was 211 minutes versus 309 minutes for RAR+SR (p<0.001, CI 60.8 - 135.4). Intra-operative blood loss for RAR was 97.8mL compared to 87.5mL for RAR+SR (p=0.924, CI -77.4 - 89.7). Conversion to open procedure occurred twice with RAR and once with RAR+SR (p=0.407). Length of hospitalization averaged 3 days for RAR and 4 days for RAR+SR (p=0.196, CI -0.2 - 2.2). The mean follow up was 127 days (range 1-72 months). Eight of 10 patients with preoperative constipation subjectively noted improvement with RAR versus 1 of 2 patients with RAR+SR (p=0.455). Six of 10 patients with preoperative fecal incontinence had subjectively improved symptoms with RAR versus 1 of 2 patients with RAR+SR (p=1.00). Six patients in the RAR group experienced a postoperative complication (over-sedation, corneal abrasion, atrial flutter, pulmonary edema, pelvic hematoma, ileus) versus 1 complication (urinary retention) after RAR+SR (p=0.924). There were no mortalities and no complications requiring operative intervention.
Conclusions : The majority of patients underwent RAR and outcomes for RAR versus RAR+SR were not significantly different in this series with the exception of increased operative time for RAR+SR. The recurrence rate was 8% and the complication rate was 27% with the majority of complications being minor complications.

	n	Recurrence	Duration of surgery (min)	Blood loss (mL)	Conversion to open	Length of hospitalization (days)	Subjective improvement in postoperative constipation	Subjective improvement in postoperative fecal incontinence	Morbidity	Mortality
RAR	22	2	210.6	97.8	2	3	8 of 10 patients	6 of 10 patients	6	0
RAR+SR	4	0	308.8	87.5	1	4	1 of 2 patients	1 of 2 patients	1	0
p value		p=1.00	p<0.001	p=0.924	p=0.407	p=0.196	p=0.455	p=1.00	p=0.924	p=1.00