Robotic-assisted laparoscopic Malone appendicostomy: a 6-year perspective
link.springer.com shows its articles on its own site.
Read the article on link.springer.com ↗Article · Feb 2024 · 1 min read
In brief
In brief
This retrospective study demonstrates that robotic-assisted laparoscopic Malone appendicostomy is safe and effective for fecal management, particularly in obese patients and those requiring combined urologic procedures. Over 6 years, 12 patients achieved 91.7% continence success with antegrade enemas, with minimal complications and the advantage of minimally invasive approach for complex reconstructive cases.
Written by the GCMD Library team from the article.
Abstract
Purpose
A robotic-assisted laparoscopic approach to appendicostomy offers the benefits of a minimally invasive approach to patients who would typically necessitate an open procedure, those with a larger body habitus, and those requiring combined complex colorectal and urologic reconstructive procedures. We present our experience performing robotic-assisted appendicostomies with a focus on patient selection, perioperative factors, and functional outcomes.
Methods
A retrospective review of patients who underwent a robotic-assisted appendicostomy/neoappendicostomy at our institution was performed.
Results
Twelve patients underwent robotic-assisted appendicostomy (n = 8) and neoappendicostomy (n = 4) at a range of 8.8–25.8 years. Five patients had a weight percentile > 50% for their age. Seven patients underwent combined procedures. Median operative time for appendicostomy/neoappendicostomy only was 185.0 min. Complications included surgical site infection (n = 3), stricture requiring minor operative revision (n = 2), conversion to an open procedure due to inadequate appendiceal length (prior to developing our technique for robotic neoappendicostomies; n = 1), and granuloma (n = 1). At a median follow-up of 10.8 months (range 1.7–74.3 months), 91.7% of patients were consistently clean with antegrade enemas.
Discussion
Robotic-assisted laparoscopic appendicostomy and neoappendicostomy with cecal flap is a safe and effective operative approach. A robotic approach can potentially overcome the technical difficulties encountered in obese patients and can aid in patients requiring both a Malone and a Mitrofanoff in a single, combined minimally invasive procedure.