Overall morbidity from robotic rectopexy in the published literature is 5–25 % with very low mortality [19, 24–28]. Morbidity may be attributed to rectal injuries, urinary infection, urinary retention, bowel obstruction, incisional hernia, hemorrhage, or wound infection.

Length of operation is a factor, which is often scrutinized when evaluating new surgical techniques. For robotic surgery this time is often divided into total operative time and the time at the robotic console. Like all other approaches, the robot has a learning curve. This may be shorter for surgeons already familiar with laparoscopic approaches. Faucheron et al. reported on their laparoscopic ventral technique in 175 cases with a mean operative time of 112 min, which was a significant decrease from a median of 240 min for their first ten patients [25]. De Hoog et al. published comparative results for open (n = 47) vs. lap (n = 15) vs. robotic (n = 20) rectopexy in 2009. Their operative times were 77, 119, and 154 min, respectively [29]. In a comparison of robotic vs. laparoscopic ventral rectopexy, Makela-Kaikkonen et al. reported a mean operative time of 159 min, mean preparation time of 26 min, mean console time of 115 min, and total time in OR 231 min for robotic cases. The matched-pair laparoscopic cases had a mean operative time of 153 and 234 min of total time in the OR [19].

The operative technique seems to effect the operation duration as well. Heemskerk et al. reported longer operative time with robotics vs. laparoscopic approach at 152 min vs. 113 min. However, they noted shorter times after they changed from Well’s posterior technique to D’Hoore’s ventral technique from 162 to 122 min in favor of D’Hoore’s [21]. Wong et al. published their early robotic experience with 40 laparoscopic ventral rectopexies vs. 23 robotic ventral rectopexies. Their robotic operative time was 221 min (setup time was 17 min) compared to 162 min in the laparoscopic cases. The robotic cases had a larger BMI (27 vs. 24) and also required double-mesh implantation more often than the laparoscopic cases, which they cite as an explanation for the longer operative time [17]. Mantoo et al. compared 44 patients treated with robotic ventral rectopexy and 74 patients treated by laparoscopic approach. Operative times were 191 and 163 min, respectively. Simultaneous levatorpexies were performed in many of these cases [26]. Perrenot et al. reported on a group of 77 consecutive patients treated with robotic ventral rectopexy. Average operating time was 223 min. The last 15 of their cases had an operative time of 175 min and the learning curve was estimated to be 18 cases where the times shortened [28].

Operative time for robotic rectopexy can approach that of laparoscopic rectopexy as the surgeon and surgical time become more familiar with the overall process. Reported time should be designated as setup, console, and overall operative time to allow the surgical team to identify aspects that can decrease overall OR time.