Robotic Redo Ileocolonic Resection for Crohn’s Disease: A Preliminary Report From a Tertiary Care Center

Aziz, Mohamed A Abd El; Abdalla, Solafah; Calini, Giacomo; Saeed, Hamadelneel; D’Angelo, Anne-Lise D.; Behm, Kevin T.; Shawki, Sherief; Mathis, Kellie L.; Larson, David W.

doi:10.1097/dcr.0000000000002380

Cited by 9 publications

(3 citation statements)

References 32 publications

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“…Robotic procedures were successfully performed in those cases, without an increase conversion rate. These results are similar from those reported by Mayo clinic, which showed no statistically signi cant difference regarding the overall length of hospital stay, the 30-day morbidity, 30-day mortality or anastomotic leaks occurred in recurrent vs non recurrent group (19). Furthermore, 30.5% of our patients had intra-abdominal stula and/or required multivisceral resections and repair.…”

Section: Discussionsupporting

confidence: 91%

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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Section: Discussionsupporting

confidence: 91%

Implementation of a robotic surgical practice in inflammatory bowel disease

Ferrari,

Nicolaou,

Adams

2024

J Robotic Surg

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“…Abd El Aziz et al investigated robotic redo ileocolic resection versus primary robotic resection. 27 A study found that compared to primary resection, redo resection had no difference in length of stay or 30-day morbidity. The only difference was in the rate of conversion to open (16.7% redo vs. 2.5% primary).…”

Section: Minimally Invasive Technique In Recurrent Diseasementioning

confidence: 99%

Minimally Invasive Management of Complicated and Re-operative Crohn's Disease

Kinford,

Poylin

2024

Clin Colon Rectal Surg

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Minimally invasive techniques for the surgical management of Crohn's disease have become the recommended approach for initial surgical intervention in noncomplicated patients as there is lower morbidity for patients without compromising treatment outcomes. There has been a push to expand minimally invasive approaches to complex and recurrent diseases, trying to benefit these difficult patients. However, until recently there have been little data to support the adoption of minimally invasive surgery (MIS) in these scenarios. This article aims to build on the 2019 Clinics in Colon and Rectal Surgery article on complex Crohn's and MIS by introducing new data in support of these approaches. Decisions for technique should be based on patient characteristics, but minimally invasive techniques have emerged as valid and possibly superior for complex and recurrent disease.

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“…The use of robotic platforms in colorectal surgery has grown exponentially over the last years 5,6 . A few reports from referral centres showed that robotic surgery is also feasible in the treatment of IBD and is associated with comparable or even improved postoperative outcomes as compared to the laparoscopic approach [7][8][9][10][11] .…”

Section: Introductionmentioning

confidence: 99%

Outcomes of robotic surgery for inflammatory bowel disease using the Medtronic Hugo™ Robotic-Assisted Surgical platform: a single centre experience

Rottoli*,

Cardelli*,

Calini

et al. 2024

Preprint

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Purpose The aim of the study was to compare the perioperative outcomes of patients who underwent surgery performed through laparoscopy or using the Medtronic Hugo™ RAS Methods This is a retrospective study from a prospectively maintained database comparing laparoscopic vs. robotic assisted surgery for IBD from 01/11/2017 to 15/04/2024. All procedures were performed by a single surgeon robotic-naïve with a large experience in laparoscopic surgery for IBD. The robotic procedures were performed using the Medtronic Hugo™ RAS platform (Medtronic, Minneapolis, MN, USA). Outcome were 30-day postoperative complications, operative time, conversion rate, intraoperative complications, length of hospital stay, and readmission rate. Results Among 121 consecutive patients, 80 underwent laparoscopic (LG) and 41 robotic-assisted surgery (RG). Baseline, preoperative and disease-specific characteristics were comparable except for older age (50 [38–56] vs. 38 [28–54] years; p = 0.05) and higher albumin (42 [40–44] vs. 40 [38–42] g/L, p = 0.006) in the RG. Intracorporeal anastomosis was more frequent in the RG (80% vs. 6%; p < 0.001) with longer operative time (240 vs. 205min; p = 0.006), while the conversion rate was not different (5% vs. 10%, p = 0.49). Postoperative complications were similar, including the rate of intra-abdominal septic complications (5% vs. 5%, p = 1), postoperative ileus (5% vs. 7.5%, p = 0.71), bleeding (2% vs. 5%, p = 0.66) and Clavien-Dindo > 2 complications (7% vs. 6%; p = 1). Conclusion IBD surgery performed using the Medtronic Hugo™ RAS is safe and feasible, with similar postoperative outcomes when compared to the laparoscopic approach. *Matteo Rottoli & Stefano Cardelli are equal first authors.

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Robotic Redo Ileocolonic Resection for Crohn’s Disease: A Preliminary Report From a Tertiary Care Center

Cited by 9 publications

References 32 publications

Implementation of a robotic surgical practice in inflammatory bowel disease

Implementation of a robotic surgical practice in inflammatory bowel disease

Minimally Invasive Management of Complicated and Re-operative Crohn's Disease

Outcomes of robotic surgery for inflammatory bowel disease using the Medtronic Hugo™ Robotic-Assisted Surgical platform: a single centre experience

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