ORIGINAL ARTICLE Day case robotic ventral rectopexy compared with day case laparoscopic ventral rectopexy: a prospective study J.-L. Faucheron 1,2,3,4 • B. Trilling 1,2 • S. Barbois 1 • P.-Y. Sage 1 • P.-A. Waroquet 1 • F. Reche 1,2 Received: 19 June 2016 / Accepted: 26 July 2016 Ó Springer International Publishing AG 2016 Abstract Background Ventral rectopexy to the promontory has become one of the most strongly advocated surgical treatments for patients with full-thickness rectal prolapse and deep enterocele. Despite its challenges, laparoscopic ventral rectopexy with or without robotic assistance for selected patients can be performed with relatively minimal patient trauma thus creating the potential for same-day discharge. The aim of this prospective case–controlled study was to assess the feasibility, safety, and cost of day case robotic ventral rectopexy compared with routine day case laparoscopic ventral rectopexy. Methods Between February 28, 2014 and March 3, 2015, 20 consecutive patients underwent day case laparoscopic ventral rectopexy for total rectal prolapse or deep entero- cele at Michallon University Hospital, Grenoble. Patients were selected for day case surgery on the basis of moti- vation, favorable social circumstances, and general fitness. One out of every two patients underwent the robotic procedure (n = 10). Demographics, technical results, and costs were compared between both groups. Results Patients from both groups were comparable in terms of demographics and technical results. Patients operated on with the robot had significantly less pain (p = 0.045). Robotic rectopexy was associated with longer median operative time (94 vs 52.5 min, p \ 0.001) and higher costs (9088 vs 3729 euros per procedure, p \ 0.001) than laparoscopic rectopexy. Conclusions Day case robotic ventral rectopexy is feasible and safe, but results in longer operative time and higher costs than classical laparoscopic ventral rectopexy for full- thickness rectal prolapse and enterocele. Keywords Rectal prolapse Á Robotic surgery Á Laparoscopy Á Rectopexy Á Day case surgery Á Minimally invasive surgery Introduction Patients with rectal prolapse and enterocele are candidates for rectopexy to the promontory [1]. Laparoscopic rec- topexy for total rectal prolapse or deep enterocele offers short-term advantages compared with the open approach: less abdominal discomfort, faster recovery, shorter hospital stay, and limited scarring [2–4]. Despite its challenges, laparoscopic anterior rectopexy for selected patients can be performed with relatively minimal patient trauma thus creating the opportunity for same-day discharge. We star- ted to operate selected patients in an ambulatory setting [4]. We have reported our experience with a miniaturized robotic laparoscope holder for rectopexy, developed in an affiliated research unit (TIMC-GMCAO, Grenoble) in a prospective randomized trial [5]. The da Vinci Si robot Presented in part at the 9th Scientific and Annual Meeting of the European Society of Coloproctology, Dublin, Ireland, 23–25 September, 2015. & J.-L. Faucheron JLFaucheron@chu-grenoble.fr 1 Colorectal Unit, Department of Surgery, Michallon University Hospital, 38000 Grenoble, France 2 University Grenoble Alps, UMR 5525, CNRS, TIMC-IMAG, 38000 Grenoble, France 3 Ambulatory Surgery, Department of Surgery, Michallon University Hospital, 38000 Grenoble, France 4 Colorectal Unit, Ambulatory Unit, Department of Surgery, Michallon University Hospital, CS 10 217, 38043 Grenoble Cedex, France 123 Tech Coloproctol DOI 10.1007/s10151-016-1518-3