Robotic and laparoscopic surgical techniques in patients with Crohn’s disease

Hota, Salini; Parascandola, Salvatore A.; Smith, Savannah; Tampo, Mayou Martin T.; Amdur, Richard L.; Obias, Vincent

doi:10.1007/s00464-020-07885-x

Cited by 23 publications

(15 citation statements)

References 20 publications

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“…Evidence on digital and robotic platform surgery applied to CD is scarce and recent, so it is still liable to selection bias. However, it seems to point to a lower occurrence of AL in patients undergoing robotic surgery (15). It has also already been verified that CD patients seem to be the most technically difficult group to apply the robotics procedures (16,17).…”

Section: Surgical Techniquementioning

confidence: 88%

Aspects Towards the Anastomotic Healing in Crohn’s Disease: Clinical Approach and Current Gaps in Research

et al. 2022

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Anastomotic leakage is a major complication in gastrointestinal and colorectal surgery and its occurrence increases morbidity and mortality. Its incidence is even higher in Crohn’s disease surgeries. Several authors have identified factors involved in the pathophysiology of anastomotic leak in the literature, aiming to reduce its occurrence and, therefore, improve its surgical treatment. Surgical technique is the most discussed topic in studies on guiding the performance of side-to-side stapled anastomosis. Preoperative nutritional therapy also has been shown to reduce the risk of anastomotic leakage. Other factors remain controversial – immunomodulator use and biologic therapy, antibiotics, and gut microbiota – with studies showing a reduction in the risk of complication while other studies show no correlation. Although mesenteric adipose tissue has been related to disease recurrence, there is no evidence in the literature that it is related to a higher risk of anastomotic leakage. Further exploration on this topic is necessary, including prospective research, to support the development of techniques to prevent anastomotic leakage, in this way benefiting the inflammatory bowel disease patients who have to undergo a surgical procedure.

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Section: Surgical Techniquementioning

confidence: 88%

Aspects Towards the Anastomotic Healing in Crohn’s Disease: Clinical Approach and Current Gaps in Research

et al. 2022

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“…This present case series examining robotic surgery in a select cohort of morbidly obese patients with ileocolic CD, who are often denied a minimally invasive operation, extends previous observations of other investigators that have shown great promise for the robotic platform for nonobese patients with CD. [13][14][15] Future larger series and formal clinical trials evaluating the role of robotic surgery in morbidly obese patients with ileocolic Crohn's disease are warranted to determine the best surgical approach for these challenging patients.…”

Section: Discussionmentioning

confidence: 99%

Morbidly Obese Patients with Ileocolic Crohn’s Disease May Benefit from Robotic Surgery

Blumberg¹

2021

JSLS

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Background and Objectives: Obesity is increasing as a comorbid condition for patients requiring surgery for Crohn's disease. Minimally invasive colectomy is ideal for a patient with combined obesity and Crohn's disease. However laparoscopic colon resection is associated with high operative conversion rates in these cases. Data examining the use of robotic surgery in the obese patient with Crohn's disease is sparse.Methods: We examined the feasibility and outcomes of performing a minimally invasive colectomy using the Da Vinci robot in a prospective case series of morbidly obese patients with ileal Crohn's disease.Results: A robotic ileocolectomy was performed in four morbidly obese patients with Crohn's disease. There were no operative conversions or complications with a median length of stay of 3 days. Conclusion:A robotic approach is a promising minimally invasive surgical alternative to laparoscopic surgery for these complex patients.

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“…Recently, a study recruited 5158 patients with CD to compare the safety of open surgery with laparoscopic and robotic-assisted ileocecal resection. 96 Results showed that laparoscopic and robotic-assisted surgery displayed lower incidences of reoperation, wound infection, and anastomotic leaks than open surgery.…”

Section: Search Strategymentioning

confidence: 98%

Intestinal strictures in Crohn’s disease: a 2021 update

Lin

Wang

Liu

et al. 2022

Therap Adv Gastroenterol

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Intestinal strictures remain one of the most intractable and common complications of Crohn’s disease (CD). Approximately 70% of CD patients will develop fibrotic strictures after 10 years of CD diagnosis. Since specific antifibrotic therapies are unavailable, endoscopic balloon dilation and surgery remain the mainstay treatments despite a high recurrence rate. Besides, there are no reliable methods for accurately evaluating intestinal fibrosis. This is largely due to the fact that the mechanisms of initiation and propagation of intestinal fibrosis are poorly understood. There is growing evidence implying that the pathogenesis of stricturing CD involves the intricate interplay of factors including aberrant immune and nonimmune responses, host-microbiome dysbiosis, and genetic susceptibility. Currently, the progress on intestinal strictures has been fueled by the advent of novel techniques, such as single-cell sequencing, multi-omics, and artificial intelligence. Here, we perform a timely and comprehensive review of the substantial advances in intestinal strictures in 2021, aiming to provide prompt information regarding fibrosis and set the stage for the improvement of diagnosis, treatment, and prognosis of intestinal strictures.

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Robotic and laparoscopic surgical techniques in patients with Crohn’s disease

Cited by 23 publications

References 20 publications

Aspects Towards the Anastomotic Healing in Crohn’s Disease: Clinical Approach and Current Gaps in Research

Aspects Towards the Anastomotic Healing in Crohn’s Disease: Clinical Approach and Current Gaps in Research

Morbidly Obese Patients with Ileocolic Crohn’s Disease May Benefit from Robotic Surgery

Intestinal strictures in Crohn’s disease: a 2021 update

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