Comparison Between Robotic Rectopexy and Perineal Approaches in the Treatment of Rectal Prolapse: A Review of the Literature.

Abstract

Rectal prolapse (RP) is the external protrusion of the rectum through the anus. It is either mucosal, where only the mucosal layer prolapses, or full thickness, with circumferential protrusion through the anus of all layers of the rectal wall. Surgery is the mainstay of treatment and can be performed via abdominal or perineal approaches. This literature review aimed to compare robotic and perineal approaches for treating RP in terms of outcomes, recurrence rates, and cost-effectiveness. PubMed was searched for all studies focusing on RP robotic and perineal approaches between 2015 and 2025. This timeframe was specifically selected to include as many studies incorporating robotic approaches as possible, as this is a relatively new technique. The review included nine studies on robotic approaches in comparison to 26 studies on perineal approaches. There was an obvious superiority of robotic approaches in terms of length of stay (LOS), recurrence rates, and improvement in incontinence, constipation, and quality of life (QoL) scores. Perineal approaches, on the other hand, showed better results regarding operative time and cost-effectiveness of the index procedure. It was concluded that robotic approaches for treating RP are more effective, offering shorter LOS, lower recurrence rates, and better patient satisfaction than perineal approaches.