Single Port Laparoscopic Surgery for Complex Crohn's Disease Is Safe with a Lower Conversion Rate

Leo, Cosimo Alex; SamaranayakeSanjeev, F; Chandrasinghe, Pramodh; ShaikhIrshad, A; HodgkinsonJonathan, D; WarusavitarneJanindra, H

doi:10.1089/lap.2016.0567

Cited by 6 publications

(2 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The single incision laparoscopic surgical (SILS) technique has also proven to be effective since it allows the easy exteriorization of the diseased segment through the port to perform complex procedures. Reduced adhesion formation allowing easier repeated surgeries is a perceived benefit of the minimal access surgery in CD (41).…”

Section: Wide Mesenteric Vs Close Dissectionmentioning

confidence: 99%

Surgical Management of Small Bowel Crohn's Disease

Chandrasinghe

2022

Front. Surg.

View full text Add to dashboard Cite

Crohn's disease in the small bowel could present itself as an inflammatory stricture, a fibrotic stricture as penetrating disease or a combination of both. It is pertinent to differentiate the disease process as well as its extent to effectively manage the disease. Currently, a combination of medical and surgical therapies forms part of the treatment plan while the debate of which therapy is better continues. In managing the strictures, identification of the disease process through imaging plays a pivotal role as inflammatory strictures respond to anti-tumor necrosis factor (TNF) and biological agents, while fibrotic strictures require endoscopic or surgical intervention. Recent evidence suggests a larger role for surgical excision, particularly in ileocolic disease, while achieving a balance between disease clearance and bowel preservation. Several adaptations to the surgical technique, such as wide mesenteric excision, side to side or Kono-S anastomosis, and long-term metronidazole therapy, are being undertaken even though their absolute benefit is yet to be determined. Penetrating disease requires a broader multidisciplinary approach with a particular focus on nutrition, skincare, and intestinal failure management. The current guidance directs toward early surgical intervention for penetrating disease when feasible. Accurate preoperative imaging, medical management of active diseases, and surgical decision-making based on experience and evidence play a key role in success.

show abstract

Section: Wide Mesenteric Vs Close Dissectionmentioning

confidence: 99%

Surgical Management of Small Bowel Crohn's Disease

Chandrasinghe

2022

Front. Surg.

View full text Add to dashboard Cite

show abstract

“…28 According to other studies comparing SILS with conventional laparoscopy, it is safe and feasible in patients with complex Crohn's disease, resulting in less need for pain medication, 29 shorter operative time, 30 and with technical advantages over multiport technique. 31 Single incision technique can be the procedure of choice especially in pediatric population and adolescent patients who have an indication for diverting ileostomy. Safe use of SILS was advocated with comparable perioperative outcomes with open surgery.…”

Section: Single Incision Laparoscopic Surgerymentioning

confidence: 99%

Minimally Invasive Surgery in Complex Crohn's Disease

Sapcı

Görgün

2019

Clinics in Colon and Rectal Surgery

View full text Add to dashboard Cite

Minimally invasive approaches are safe, feasible, and often recommended as the initial choice in the surgical management of Crohn's disease. However, a consensus has not been reached as the ideal approach in the surgical treatment of complex and recurrent Crohn's disease. Laparoscopy may provide advantages such as shorter length of stay and decreased postoperative pain and result in less adhesion formation in patients with complex disease. Robotic techniques may be beneficial in selected patients for completion proctectomy, providing better visualization in the narrow pelvis and increased dexterity. Decision of surgical technique should be made on a case-by-case basis.

show abstract