Laparoscopic restorative proctocolectomy: safety and critical level of the ileal pouch anal anastomosis

Abstract

In laparoscopic-assisted RPC a limited Pfannenstiel incision allows safe construction of the IPAA at an appropriate level. Laparoscopic RPC is safe and the emerging long-term follow-up data show the benefit of this approach, with very low rates of small bowel obstruction and incisional hernia formation.

Safety, feasibility, and short-term outcomes in 588 patients undergoing minimally invasive ileal pouch-anal anastomosis: a single-institution experience

“…Our finding that MIS-IPAA is safe and feasible and associated with short-term patient benefits is consistent with what has been reported by others. The conversion rate of 8 % seen in our series falls within the observed range of 1.4-13 % across other studies [18][19][20][21][22][23]. Mortality, postoperative complications and length of hospital stay reported in other series are also similar to those in our study.…”

Short-term Outcome of Robot-assisted and Open IPAA

“…it is likely that the laparoscopic approach benefits patients in many important medium-and longterm aspects, eg, in terms of lower morbidity and faster recovery following the subsequent restoration of bowel continuity, 32 in addition to increased fecundity 6,7 and presumably a lower risk of incisional hernias. 33 although the power of this study predominantly lies in the considerable volume of Ral-iPaa procedures, there are several limitations, the most important of which is the observational single-center design, which imposes restrictions to the transferability of our results. furthermore, the overall economic feasibility of Ral was not determined, because we did not compare the costs of the 2 procedures.…”

Laparoscopic IPAA Is Not Associated With Decreased Rates of Incisional Hernia and Small-Bowel Obstruction When Compared With Open Technique

“…30,34 in addition, at least 3 different studies have concurrently found that laparoscopic iPaa is associated with decreased rates of adhesions, possibly because of decreased small-bowel manipulation and incision length, 11-13 2 of which evaluated patients undergoing laparoscopic rectal dissection. 30,34 in addition, at least 3 different studies have concurrently found that laparoscopic iPaa is associated with decreased rates of adhesions, possibly because of decreased small-bowel manipulation and incision length, 11-13 2 of which evaluated patients undergoing laparoscopic rectal dissection.…”