Robot-assisted mesh rectosacropexy and sigmoid colon resection for obstructive defecation syndrome: a two-stage surgical approach.

Abstract

Obstructive Defecation Syndrome (ODS) significantly affects the quality of life and is often associated with rectocele, rectoanal intussusception, and dolichosigma. Robot-assisted rectosacropexy followed by sigmoid resection may offer an effective therapeutic approach. This study included 7 female patients (mean age 61.14 years, BMI 27.17) with confirmed ODS and no prior treatment for rectal prolapse or dolichosigma. Using standardized scores (Wexner, Altomare ODS), outcomes were assessed preoperatively and at 1, 3, and 6 months postoperatively. Robot-assisted rectosacropexy with mesh placement and subsequent sigmoid resection were performed in two surgical stages. Significant improvements in constipation (Wexner score reduced from 14.1 to 8.7, p < 0.01) and ODS symptoms (Altomare ODS score from 19.1 to 5.6, p < 0.01) were noted at 6 months. Continence (Wexner Incontinence Score) improved from 13.4 to 7.1. No conversions or major complications occurred, and all patients reported satisfaction with the treatment. Robot-assisted rectosacropexy followed by sigmoid resection is a safe and effective two-step approach for ODS. Further studies are needed to explore its long-term efficacy and functional outcomes.