Does laparoscopic ileal pouch-anal anastomosis reduce infertility compared with open approach?

Inflammatory bowel disease position statement of the Italian Society of Colorectal Surgery (SICCR): ulcerative colitis

“…There are many recent studies that report how infertility rates after laparoscopic RP are significantly lower than those seen after open surgery [103,161] and this can be explained by a reduction of pelvic adhesions. However, similar rates of infertility have also been reported in patients undergoing either laparoscopic (61.1%) or open (65%) IPAA [91,162].…”

“…Some authors reported lower rates of infertility with laparoscopic surgery [161,188]. However, a recent study [162] conducted on 161 women with IPAA, who tried to conceive, found no difference in infertility rates between laparoscopic (61.1%) and open IPAA (65%, p = 0.69); laparoscopic IPAA was associated with a significantly reduced time to conceive (3.5 months vs 9 months, respectively, log-rank p = 0.01). In recent years, some techniques have been proposed to prevent infertility during surgery, including oophoropexy, intraoperative, adhesiolysis, interposition of the omentum, pedicled graft to separate ovaries from pelvis [189,190].…”

Medical therapy versus surgery in moderate-to-severe ulcerative colitis

“…On the other hand, surgery may limit fecundity and fertility in women, and this should be carefully discussed with female fertile patients. Recent large studies suggest that laparoscopic IPAA represents the best solution in this case, as it is associated with lower rates of infertility, higher rates of pregnancies, and reduced time to pregnancy after surgery, compared to open approach [70][71][72] .…”

Benefits of Elective Laparoscopic 2-Stage Restorative Proctocolectomy for Ulcerative Colitis in Korea

“…When surgery types were compared to each other, the postoperative morbidity for the laparoscopic approach appeared significantly lower than open surgery (24% and 53%, respectively; P = 0.0386) together with a significantly shorter time of bowel function recovery (2.6 days and 5.5 days, respectively; P = 0.0001). In some studies, laparoscopic surgery appeared to require more time than open surgery [7][8][9].…”

“…In a study conducted by Chung et al [6], surgeons utilized laparoscopic-and open surgeries as the initial operation among the 3-stage RPC procedures for severe UC.When surgery types were compared to each other, the postoperative morbidity for the laparoscopic approach appeared significantly lower than open surgery (24% and 53%, respectively; P = 0.0386) together with a significantly shorter time of bowel function recovery (2.6 days and 5.5 days, respectively; P = 0.0001). In some studies, laparoscopic surgery appeared to require more time than open surgery [7][8][9].Bong et al[10] compared the short-term outcomes of the open and laparoscopic approaches to 2-stage RPC for patients suffering from refractory UC and UC with dysplasia. The patients in the laparoscopic surgery group had lower mean body mass index (P = 0.025), shorter bowel function recovery time (P = 0.004), and less postoperative day (POD) 1 and POD 7 pain (P = 0.029 and P = 0.027, respectively), than those in the open surgery group.…”