Short-term Results After Totally Robotic Restorative Total Proctocolectomy With Ileal Pouch Anal Anastomosis for Ulcerative Colitis

Hamzaoğlu, İsmail; Baca, Bilgi; Esen, Eren; Aytaç, Erman; Özben, Volkan; Aghayeva, Afag; Bilgin, İsmail Ahmet; Karahasanoğlu, Tayfun

doi:10.1097/sle.0000000000000645

Cited by 17 publications

(11 citation statements)

References 20 publications

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“…Based on the quality assessment described by Murad ( 23 ), 3 series received a score of 6/8 ( 41 , 43 , 47 ) and 5 received a grade of 5/8 ( 1 , 42 , 44 – 46 ). Overall, the 23 studies were considered at high risk of bias.…”

Section: Resultsmentioning

confidence: 99%

“…This strategy is in accordance with Protyniak et al ( 8 ), who demonstrated that the Xi platform can be used for multiquadrant surgery without repositioning the patient-side surgical cart. Recently two comparative studies ( 7 , 39 ) and two case series ( 46 , 47 ) evaluated the da Vinci Xi surgical system and multiquadrant surgery for TC, STC, and restorative TPC, using a totally robotic approach. All authors agreed that the robotic platform offered a significant advantage over the previous generations.…”

Section: Discussionmentioning

confidence: 99%

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Robotic multiquadrant colorectal procedures: A single-center experience and a systematic review of the literature

et al. 2022

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PurposeRobotic surgery has been progressively implemented for colorectal procedures but is still limited for multiquadrant abdominal resections. The present study aims to describe our experience in robotic multiquadrant colorectal surgeries and provide a systematic review and meta-analysis of the literature investigating the outcomes of robotic total proctocolectomy (TPC), total colectomy (TC), subtotal colectomy (STC), or completion proctectomy (CP) compared to laparoscopy.MethodsAt our institution 16 consecutive patients underwent a 2- or 3-stage totally robotic total proctocolectomy (TPC) with ileal pouch-anal anastomosis. A systematic review of the literature was performed to select studies on robotic and laparoscopic multiquadrant colorectal procedures. Meta-analyses were used to compare the two approaches.ResultsIn our case series, 14/16 patients underwent a 2-stage robotic TPC for ulcerative colitis with a mean operative time of 271.42 (SD:37.95) minutes. No conversion occurred. Two patients developed postoperative complications. The mean hospital stay was 8.28 (SD:1.47) days with no readmissions. Mortality was nil. All patients underwent loop-ileostomy closure, and functional outcomes were satisfactory. The literature appraisal was based on 23 retrospective studies, including 736 robotic and 9,904 laparoscopic multiquadrant surgeries. In the robotic group, 36 patients underwent STC, 371 TC, 166 TPC, and 163 CP. Pooled data analysis showed that robotic TC and STC had a lower conversion rate (OR = 0.17;95% CI, 0.04–0.82; p = 0.03) than laparoscopic TC and STC. The robotic approach was associated with longer operative time for TC and STC (MD = 104.64;95% CI, 18.42–190.87; p = 0.02) and TPC and CP (MD = 38.8;95% CI, 18.7–59.06; p = 0.0002), with no differences for postoperative complications and hospital stay. Reports on urological outcomes, sexual dysfunction, and quality of life were missing.ConclusionsOur experience and the literature suggest that robotic multiquadrant colorectal surgery is safe and effective, with low morbidity and mortality rates. Nevertheless, the overall level of evidence is low, and functional outcomes of robotic approach remain largely unknown. Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/, identifier: CRD42022303016.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Robotic multiquadrant colorectal procedures: A single-center experience and a systematic review of the literature

et al. 2022

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“…Nine comparative studies and 3 cases series of robotic IPAA where the proctectomy was performed robotically have been published to date. 7–15…”

Section: Proctectomymentioning

confidence: 99%

Robotic Surgery for the Ileal Pouch

Lynch

2022

Diseases of the Colon &Amp; Rectum

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BACKGROUND:A robotic approach to total colectomy/ proctectomy and ileal pouch reconstruction would seem to be a sensible use of the platform's enhanced reach, visualization, and dexterity. OBJECTIVE:The study aimed to discuss current published data for robotic ileal pouch surgery. STUDY SELECTION:The study selection included a paucity of published data to date, representing early learning curves and case series with small numbers.CONCLUSIONS: Current robotic platforms may offer advantages, particularly in the low pelvis beyond what is found with a laparoscopic approach.

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“…They also advocated specifically for the use of robotic stapler which allows the surgeon to control the rectal transection and may reduce the risk of anastomotic leak and rectal cuff problems. 15…”

Section: Total Proctocolectomymentioning

confidence: 99%

“…Multiple case series have examined the short- and intermediate-term outcomes of robotic STC, TPC/IPAA, and completion proctectomy/IPAA for UC, demonstrating that these approaches are safe and feasible, with shorter length of stay, earlier stoma function, less blood loss, low-leak rates, and equal morbidity and mortality to their laparoscopic counterpart operations. 15 The following pages describe our technique and experience with robotic STC and end ileostomy in the urgent setting, as well as robotic IPAA creation (stage 2 of the three-stage procedure), as well as the robotic experience with TPC for UC.…”

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confidence: 99%

Robotic Surgery for Ulcerative Colitis

Anderson

Grucela

2021

Clin Colon Rectal Surg

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Subtotal colectomy (STC) or total proctocolectomy (TPC) and ileal pouch–anal anastomosis (IPAA) performed in two or three stages remain the procedure of choice for patients with ulcerative colitis (UC). Minimally invasive laparoscopic approaches for STC and IPAA have been established for over a decade, having been shown to reduce postoperative pain, length of stay, and improve fertility. However “straight-stick” laparoscopy has ergonomic and visual disadvantages in the pelvis, which may contribute to IPAA failure. The robotic platform was developed to overcome these limitations. Robotic STC is associated with lower conversion rates and earlier return of bowel function with acceptably longer operative time (mean, 28 minutes) than laparoscopic STC. The robotic approach has also been shown in case series to be safe in urgent settings. Robotic IPAA is associated with lower blood loss and length of stay than laparoscopic IPAA. Robotic TPC/IPAA has been shown in small case series to be safe and feasible despite longer operating times.

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Short-term Results After Totally Robotic Restorative Total Proctocolectomy With Ileal Pouch Anal Anastomosis for Ulcerative Colitis

Cited by 17 publications

References 20 publications

Robotic multiquadrant colorectal procedures: A single-center experience and a systematic review of the literature

Robotic multiquadrant colorectal procedures: A single-center experience and a systematic review of the literature

Robotic Surgery for the Ileal Pouch

Robotic Surgery for Ulcerative Colitis

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