{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T11:38:57Z","timestamp":1774611537638,"version":"3.50.1"},"reference-count":23,"publisher":"MDPI AG","issue":"17","license":[{"start":{"date-parts":[[2023,9,4]],"date-time":"2023-09-04T00:00:00Z","timestamp":1693785600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Introduction: Laparoscopic ventral mesh rectopexy (VMR) is the standard procedure for the treatment of posterior pelvic organ prolapse. Despite significant functional improvement and anatomical corrections, severe complications related to mesh augmentation can occur in a few proportions of patients. In order to decrease the number of rare but severe complications, we developed a variant of the conventional VMR without any rectal fixation and using a robotic approach with biological mesh. The aim of this study was to compare the results of laparoscopic ventral rectopexy with synthetic mesh (LVMRS) to those of robotic ventral rectopexy with biological mesh (RVMRB). Methods: Between 2004 and 2021, patients operated on for VMR in our unit were identified and separated into two groups: LVMRS and RVMRB. The surgical technique for both groups consisted of VMR without any rectal fixation, with mesh distally secured on the levator ani muscles. Results: 269 patients with a mean age of 62 years were operated for posterior pelvic floor disorder: rectocele (61.7%) and external rectal prolapse (34.6%). 222 (82.5%) patients received LVMRS (2004\u20132015), whereas 47 were operated with RVMRB (2015\u20132021). Both groups slightly differed for combined anterior fixation proportion (LVMRS 39% vs. RVMRB 6.4%, p &lt; 0.001). Despite these differences, the length of stay was shorter in the RVMRB group (2 vs. 3 days, p &lt; 0.001). Postoperative complications were comparable in the two groups (1.8 vs. 4.3%, p = 0.089) and mainly consisted of minor complications. Functional outcomes were favorable and similar in both groups, with an improvement in bulging, obstructed defecation symptoms, and fecal incontinence (NS in subgroup analysis). In the long term, there were no mesh erosions reported. The overall recurrence rate was 11.9%, and was comparable in the two groups (13% LVMRS vs. 8.5, p = 0.43). Conclusions: VMR without rectal fixation is a safe and effective approach in posterior organ prolapse management. RVMRB provides comparable results in terms of recurrence and functional results, with avoidance of unabsorbable material implantation.<\/jats:p>","DOI":"10.3390\/jcm12175751","type":"journal-article","created":{"date-parts":[[2023,9,4]],"date-time":"2023-09-04T10:24:30Z","timestamp":1693823070000},"page":"5751","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Moving from Laparoscopic Synthetic Mesh to Robotic Biological Mesh for Ventral Rectopexy: Results from a Case Series"],"prefix":"10.3390","volume":"12","author":[{"given":"Farouk","family":"Drissi","sequence":"first","affiliation":[{"name":"Department of Digestive Surgery, University Hospital of Nantes, 1 Place Alexis Ricordeau, 44093 Nantes, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fabien","family":"Rogier-Mouzelas","sequence":"additional","affiliation":[{"name":"Department of Digestive Surgery, University Hospital of Nantes, 1 Place Alexis Ricordeau, 44093 Nantes, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9716-9157","authenticated-orcid":false,"given":"Sebastian","family":"Fernandez Arias","sequence":"additional","affiliation":[{"name":"Hospital Vital Alvarez Buylla, 33611 Mieres, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juliette","family":"Podevin","sequence":"additional","affiliation":[{"name":"Department of Digestive Surgery, University Hospital of Nantes, 1 Place Alexis Ricordeau, 44093 Nantes, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guillaume","family":"Meurette","sequence":"additional","affiliation":[{"name":"Division of Digestive Surgery, University Hospitals of Geneva, 1211 Geneva, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,9,4]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1500","DOI":"10.1002\/bjs.4779","article-title":"Long-Term Outcome of Laparoscopic Ventral Rectopexy for Total Rectal Prolapse","volume":"91","author":"Cadoni","year":"2004","journal-title":"Br. J. Surg."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"2444","DOI":"10.1007\/s00464-019-06803-0","article-title":"Outcome of Laparoscopic Ventral Mesh Rectopexy for Full-Thickness External Rectal Prolapse: A Systematic Review, Meta-Analysis, and Meta-Regression Analysis of the Predictors for Recurrence","volume":"33","author":"Emile","year":"2019","journal-title":"Surg. Endosc."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"e459","DOI":"10.1097\/SLA.0000000000004559","article-title":"Patients\u2019 Perception of Long-Term Outcome After Laparoscopic Ventral Mesh Rectopexy; Single Tertiary Center Experience","volume":"276","author":"Singh","year":"2022","journal-title":"Ann. Surg."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"529","DOI":"10.1007\/s10151-019-02014-w","article-title":"Robotic vs. Laparoscopic Ventral Mesh Rectopexy for External Rectal Prolapse and Rectal Intussusception: A Systematic Review","volume":"23","author":"Albayati","year":"2019","journal-title":"Tech. Coloproctol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1007\/s10151-013-1042-7","article-title":"Robotic-Assisted and Laparoscopic Ventral Rectopexy in the Treatment of Rectal Prolapse: A Matched-Pairs Study of Operative Details and Complications","volume":"18","author":"Rautio","year":"2014","journal-title":"Tech. Coloproctol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"930","DOI":"10.1007\/s00464-019-06851-6","article-title":"Long-Term Outcomes of Robotic Ventral Mesh Rectopexy for External Rectal Prolapse","volume":"34","author":"Postillon","year":"2020","journal-title":"Surg. Endosc."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"4977","DOI":"10.3748\/wjg.v22.i21.4977","article-title":"Current Status of Laparoscopic and Robotic Ventral Mesh Rectopexy for External and Internal Rectal Prolapse","volume":"22","author":"Paulides","year":"2016","journal-title":"WJG"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"858","DOI":"10.1111\/codi.12177","article-title":"The PROSPER Collaborative Group PROSPER: A Randomised Comparison of Surgical Treatments for Rectal Prolapse","volume":"15","author":"Senapati","year":"2013","journal-title":"Colorectal. Dis."},{"key":"ref_9","first-page":"e14175","article-title":"Laparoscopic Versus Open Rectopexy for Rectal Prolapse: A Randomized Controlled Trial","volume":"13","author":"Mohapatra","year":"2021","journal-title":"Cureus"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"953","DOI":"10.1007\/s10151-022-02679-w","article-title":"International Robotic Rectopexy Delphi Group Using a Modified Delphi Process to Explore International Surgeon-Reported Benefits of Robotic-Assisted Surgery to Perform Abdominal Rectopexy","volume":"26","author":"Keating","year":"2022","journal-title":"Tech. Coloproctol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"46","DOI":"10.3393\/ac.2017.33.2.46","article-title":"Synthetic Versus Biological Mesh-Related Erosion After Laparoscopic Ventral Mesh Rectopexy: A Systematic Review","volume":"33","author":"Balla","year":"2017","journal-title":"Ann. Coloproctol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"650","DOI":"10.1111\/codi.12219","article-title":"Synthetic or Biological Mesh Use in Laparoscopic Ventral Mesh Rectopexy\u2014A Systematic Review","volume":"15","author":"Smart","year":"2013","journal-title":"Colorectal. Dis."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1007\/s10151-021-02534-4","article-title":"Mesh-Related Complications and Recurrence after Ventral Mesh Rectopexy with Synthetic versus Biologic Mesh: A Systematic Review and Meta-Analysis","volume":"26","author":"Boom","year":"2022","journal-title":"Tech. Coloproctol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"82","DOI":"10.1111\/codi.12415","article-title":"Consensus on Ventral Rectopexy: Report of a Panel of Experts","volume":"16","author":"Dixon","year":"2014","journal-title":"Colorectal. Dis."},{"key":"ref_15","unstructured":"(2023, June 27). Arr\u00eat\u00e9 Du 22 Septembre 2021 Encadrant La Pratique Des Actes Associ\u00e9s \u00e0 La Pose d\u2019implants de Suspension Destin\u00e9s Au Traitement Du Prolapsus Des Organes Pelviens Chez La Femme Par Voie Chirurgicale Haute En Application Des Dispositions de l\u2019article L. 1151-1 Du Code de Sant\u00e9 Publique\u2014L\u00e9gifrance. Available online: https:\/\/Www.Legifrance.Gouv.Fr\/Jorf\/Id\/JORFTEXT000044087701."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"188","DOI":"10.1016\/j.jviscsurg.2022.09.009","article-title":"Anatomic and Functional Results of Ventral Biological Mesh Rectopexy for Posterior Pelvic Floor Disorders","volume":"160","author":"Drissi","year":"2023","journal-title":"J. Visc. Surg."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1007\/s10151-021-02563-z","article-title":"Mid-Term Functional and Quality of Life Outcomes of Robotic and Laparoscopic Ventral Mesh Rectopexy: Multicenter Comparative Matched-Pair Analyses","volume":"26","author":"Laitakari","year":"2022","journal-title":"Tech. Coloproctol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1621","DOI":"10.1007\/s00384-021-03904-y","article-title":"Robotic versus Laparoscopic Ventral Mesh Rectopexy: A Systematic Review and Meta-Analysis","volume":"36","author":"Flynn","year":"2021","journal-title":"Int. J. Colorectal. Dis."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"e469","DOI":"10.1111\/codi.12251","article-title":"Is Robotic-Assisted Ventral Mesh Rectopexy Superior to Laparoscopic Ventral Mesh Rectopexy in the Management of Obstructed Defaecation?","volume":"15","author":"Mantoo","year":"2013","journal-title":"Colorectal. Dis."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1113","DOI":"10.1007\/s00384-014-1937-4","article-title":"Short-Term Outcome of Laparoscopic versus Robotic Ventral Mesh Rectopexy for Full-Thickness Rectal Prolapse. Is Robotic Superior?","volume":"29","author":"Mehmood","year":"2014","journal-title":"Int. J. Colorectal. Dis."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1010","DOI":"10.1111\/codi.13309","article-title":"Robot-Assisted vs. Laparoscopic Ventral Rectopexy for External or Internal Rectal Prolapse and Enterocele: A Randomized Controlled Trial","volume":"18","author":"Rautio","year":"2016","journal-title":"Colorectal. Dis."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"991","DOI":"10.1007\/s10151-022-02689-8","article-title":"Treatment of Recurrent Rectal Prolapse after a Laparoscopic Ventral Mesh Rectopexy","volume":"26","author":"Brown","year":"2022","journal-title":"Tech. Coloproctol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"573","DOI":"10.1007\/s10151-020-02199-5","article-title":"Laparoscopic sacrocolpopexy plus ventral rectopexy as combined treatment for multicompartment pelvic organ prolapse","volume":"24","author":"Campagna","year":"2020","journal-title":"Tech. Coloproctol."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/17\/5751\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T20:46:04Z","timestamp":1760129164000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/17\/5751"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,9,4]]},"references-count":23,"journal-issue":{"issue":"17","published-online":{"date-parts":[[2023,9]]}},"alternative-id":["jcm12175751"],"URL":"https:\/\/doi.org\/10.3390\/jcm12175751","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,9,4]]}}}