Ileocolic resection for Crohn’s disease: robotic intracorporeal compared to laparoscopic extracorporeal anastomosis

Calini, Giacomo; Abdalla, Solafah; Aziz, Mohamed A Abd El; Merchea, Amit; Larson, David W.; Behm, Kevin T.

doi:10.1007/s11701-023-01635-6

Cited by 5 publications

(1 citation statement)

References 51 publications

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“…There are advantages of ICA including using off midline extraction, better pain control, and earlier return to bowel function minimizes potential tension placed on thickened and foreshorten mesentery and this will likely lead to further improvements in recovery within our future patient cohorts. Previous studies have proven the safety of ICA in CD after ileo-colonic anastomosis in single centre retrospective studies (20)(21)(22)(23), while two trials comparing ICA and ECA are still ongoing (NCT03019016, NCT03862781), but results are still pending.…”

Section: Discussionmentioning

confidence: 99%

Implementation of a robotic surgical practice in inflammatory bowel disease

Ferrari,

Nikolaou,

Adams

2023

Preprint

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Background Robotics adoption has increased in colorectal surgery. While there are well-established advantages and standardised techniques for cancer patients, the use of robotic surgery in inflammatory bowel disease (IBD) hasn’t been studied yet. Objective To evaluate the feasibility and safety of robotic surgery for IBD patients. Methods Prospectively data in IBD patients having robotic resection at Guy’s and St Thomas’ hospital. All resections performed by a single colorectal surgeon specialised in IBD, utilising Da-Vinci platform. Results July 2021 to January 2023, 59 robotic IBD cases performed, 14 ulcerative colitis (UC) and 45 Crohn’s disease (CD). Average age; CD patients 35, UC 33 years. Average Body mass index (BMI); 23 for CD and 26.9 for UC patients. In total, we performed 31 ileo-caecal resections (ICR) with primary anastomosis (18 Kono-S anastomosis, 6 mechanical anastomosis and 7 ileo-colostomy), of those 4 had multivisceral resections (large bowel, bladder, ovary). Furthermore, 14 subtotal colectomy (1 emergency), 8 proctectomy, 3 panproctocolectomy and 3 ileo-anal J pouch. 18 of the 45 patients (45.0%) with crohn’s disease had ongoing fistulating disease to other parts of the GI tract (small or large bowel). ICR were performed using different 3 ports position, depending on the anatomy established prior to surgery with magnetic resonance images (MRI). One patient had conversion to open due to anaesthetic problems and one patient required re-operation to refashion stoma. 98.0% cases completed robotically. Median Length of hospital stay (LOS) was 7 days for CD and 7 for UC cases, including LOS in patients on pre-operative parenteral nutrition. Conclusions Robotic colorectal techniques can be safely used for patients with IBD, even with fistulating disease. Future research and collaborations are necessary to standardize technique within institutions.

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Section: Discussionmentioning

confidence: 99%

Implementation of a robotic surgical practice in inflammatory bowel disease

Ferrari,

Nikolaou,

Adams

2023

Preprint

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Anastomotic Techniques for Crohn’s Surgery

Spinelli,

Paoluzzi Tomada

2024

Coloproctology

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Implementation of a robotic surgical practice in inflammatory bowel disease

Ferrari,

Nicolaou,

Adams

2024

J Robotic Surg

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BackgroundRobotics adoption has increased in colorectal surgery. While there are well-established advantages and standardised techniques for cancer patients, the use of robotic surgery in in ammatory bowel disease (IBD) hasn't been studied yet. ObjectiveTo evaluate the feasibility and safety of robotic surgery for IBD patients. MethodsProspectively data in IBD patients having robotic resection at Guy's and St Thomas' hospital. All resections performed by a single colorectal surgeon specialised in IBD, utilising Da-Vinci platform. ResultsJuly 2021 to January 2023, 59 robotic IBD cases performed, 14 ulcerative colitis (UC) and 45 Crohn's disease (CD). Average age; CD patients 35, UC 33 years. Average Body mass index (BMI); 23 for CD and 26.9 for UC patients.In total, we performed 31 ileo-caecal resections (ICR) with primary anastomosis (18 Kono-S anastomosis, 6 mechanical anastomosis and 7 ileo-colostomy), of those 4 had multivisceral resections (large bowel, bladder, ovary). Furthermore, 14 subtotal colectomy (1 emergency), 8 proctectomy, 3 panproctocolectomy and 3 ileo-anal J pouch. 18 of the 45 patients (45.0%) with crohn's disease had ongoing stulating disease to other parts of the GI tract (small or large bowel). ICR were performed using different 3 ports position, depending on the anatomy established prior to surgery with magnetic resonance images (MRI). One patient had conversion to open due to anaesthetic problems and one patient required re-operation to refashion stoma. 98.0% cases completed robotically. Median Length of hospital stay (LOS) was 7 days for CD and 7 for UC cases, including LOS in patients on pre-operative parenteral nutrition. ConclusionsRobotic colorectal techniques can be safely used for patients with IBD, even with stulating disease.Future research and collaborations are necessary to standardize technique within institutions.

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Ileocolic resection for Crohn’s disease: robotic intracorporeal compared to laparoscopic extracorporeal anastomosis

Cited by 5 publications

References 51 publications

Implementation of a robotic surgical practice in inflammatory bowel disease

Implementation of a robotic surgical practice in inflammatory bowel disease

Anastomotic Techniques for Crohn’s Surgery

Implementation of a robotic surgical practice in inflammatory bowel disease

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