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- Title
Robotic-assisted reoperative ileal pouch–anal anastomosis: robotic pouch excision and pouch revision.
- Authors
Violante, Tommaso; Behm, Kevin T.; Shawki, Sherief F.; Ferrari, Davide; D'Angelo, Anne-Lise D.; Kelley, Scott R.; Nitin, Mishra; Larson, David W.
- Abstract
Background: Up to 20% of patients with ileal pouch will develop pouch failure, ultimately requiring surgical reintervention. As a result of the complexity of reoperative pouch surgery, minimally invasive approaches were rarely utilized. In this series, we present the outcomes of the patients who underwent robotic-assisted pouch revision or excision to assess its feasibility and short-term results. Methods: All the patients affected by inflammatory bowel diseases and familial adenomatous polyposis who underwent robotic reoperative surgery of an existing ileal pouch were included. Results: Twenty-two patients were included; 54.6% were female. The average age at reoperation was 51 ± 16 years, with a mean body mass index of 26.1 ± 5.6 kg/m2. Fourteen (63.7%) had a diagnosis of ulcerative colitis at reoperation, and seven (31.8%) had Crohn's disease. The mean time to pouch reoperation was 12.8 ± 11.8 years. Seventeen (77.3%) patients underwent pouch excision, and five (22.7%) had pouch revision surgery. The mean operative time was 372 ± 131 min, and the estimated blood loss was 199 ± 196.7 ml. The conversion rate was 9.1%, the 30-day morbidity rate was 27.3% (with only one complication reaching Clavien–Dindo grade IIIB), and the mean length of stay was 5.8 ± 3.9 days. The readmission rate was 18.2%, the reoperation rate was 4.6%, and mortality was nihil. All patients in the pouch revisional group are stoma-free. Conclusion: Robotic reoperative pouch surgery in highly selected patients is technically feasible with acceptable outcomes.
- Subjects
RESTORATIVE proctocolectomy; INFLAMMATORY bowel diseases; CROHN'S disease; REOPERATION; ADENOMATOUS polyposis coli; BLOOD loss estimation
- Publication
Techniques in Coloproctology, 2024, p1
- ISSN
1123-6337
- Publication type
Article
- DOI
10.1007/s10151-024-02918-2