Laparoscopic robotic-assisted ileo-caecal resection with intracorporeal anastomosis in children with Crohn disease: initial experience of a paediatric center and surgical feasibility
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In brief
In brief
This study reports initial experience with robotic-assisted ileocecal resection using intracorporeal anastomosis in six pediatric Crohn's disease patients. The technique proved safe and feasible with no conversions, though one anastomotic complication required reoperation. The robotic platform's 3D visualization and precision may offer advantages for creating intracorporeal anastomoses in children.
- Robotic ileocecal resection with intracorporeal anastomosis is safe and feasible in pediatric Crohn's disease patients (mean age 14.8 years).
- 3D visualization and enhanced dexterity of robotic platform facilitates precise intracorporeal anastomosis creation without need for extraction.
- Mean operative time was 210.8 minutes with no intraoperative complications or conversions to open surgery in initial 6-patient series.
- Postoperative recovery showed bowel function return by day 3 and mean hospital stay of 8 days with low complication rate (1 major, 2 minor).
- Robotic approach may offer technical advantages over conventional laparoscopy for complex anastomoses in pediatric inflammatory bowel disease surgery.
Written by the GCMD Library team from the article.
Abstract
Purpose
Pediatric-onset Crohn's disease (CD) presents with a more aggressive course than adults. Surgical treatment is still necessary in many patients. The laparoscopic technique for treating terminal ileal CD is deemed safe and feasible, with the advantage to perform an intra-corporeal anastomosis (ICA). The robotic platform facilitates ICA creation thanks to 3D-visualization, tenfold magnification and better dexterity. The aim of this study was to report our initial experience of robotic ileocecal resection (RICR) with ICA in children with CD.
Methods
Six patients underwent RICR for CD. Patient characteristics, intraoperative details, and postoperative outcomes were collected. The surgical technique consisted in an intra-corporeal ICR with a stapled side-to-side ileo-colic anastomosis.
Results
The mean age at surgery was 14.8 years. The mean operative time was 210.8 min. No intraoperative complications or conversions were recorded. Bowel function returned on postoperative day 3 and the mean hospital stay was 8 days. Two minor complications were treated conservatively and 1 major (anastomotic dehiscence) required reoperation.
Conclusion
RICR is a safe and feasible technique in pediatric CD of terminal ileum. The robot offers advantages over other techniques for the precision of the suture, avoiding extracorporeal anastomosis. However, larger studies are needed to confirm these preliminary results.