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Ileocolic resection for Crohn’s disease: robotic intracorporeal compared to laparoscopic extracorporeal anastomosis

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Abstract

Laparoscopy is the first-line approach in ileocolic resection for Crohn’s disease. Emerging data has shown better short-term outcomes with robotic right colectomy for cancer when compared to laparoscopic approach. However, robotic ileocolic resection for Crohn’s disease has only shown faster return to bowel function. We aimed to evaluate short-term outcomes of ileocolic resection for Crohn’s disease between robotic intracorporeal anastomosis (RICA) and laparoscopic extracorporeal anastomosis (LECA). Patients undergoing minimally invasive ileocolic resections for Crohn’s disease were retrospectively identified using a prospectively maintained database between 2014 and 2021 in two referral centers. Among the 239 patients, 70 (29%) underwent RICA while 169 (71%) LECA. Both groups were similar according to baseline and preoperative characteristics. RICA was associated with more intraoperative adhesiolysis and longer operative time [RICA: 238 ± 79 min vs. LECA: 143 ± 52 min; p < 0.001]. 30-day postoperative complications were not different between the two groups [RICA: 17/70(24%) vs. LECA: 54/169(32%); p = 0.238]. Surgical site infections [RICA: 0/70 vs. LECA: 16/169(10%); p = 0.004], intra-abdominal septic complications [RICA: 0/70 vs. LECA: 14/169(8%); p = 0.012], and Clavien-Dindo ≥ III complications [RICA: 1/70(1%) vs. LECA: 15/169(9%); p = 0.044] were less frequent in RICA. Return to bowel function [RICA: 2.1 ± 1.1 vs. LECA: 2.6 ± 1.2 days; p = 0.002] and length of stay [RICA: 3.4 ± 2.2 vs. LECA: 4.2 ± 2.5 days; p = 0.015] were shorter after RICA, with similar readmission rates. RICA demonstrated better short-term postoperative outcomes than LECA, with reduced Clavien-Dindo ≥ III complications, surgical site infections, intra-abdominal septic complications, shorter length of stay, and faster return to bowel function, despite the longer operative time.

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Data availability

The data that support the findings of this study are not openly available due to reasons of sensitivity and are available from the corresponding authors upon reasonable request.

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Author notes

  1. Giacomo Calini

    Present address: Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, Bologna, Italy

Authors and Affiliations

  1. Division of Colon and Rectal Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA

    Giacomo Calini, Solafah Abdalla, Mohamed A. Abd El Aziz, David W. Larson & Kevin T. Behm

  2. Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, Bologna, Italy

    Amit Merchea

  3. Division of Colon and Rectal Surgery, Mayo Clinic, Jacksonville, FL, USA

    Amit Merchea

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  1. Giacomo Calini
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Contributions

All authors contributed to the study conception and design, critically reviews the manuscript, and approved the final manuscript. GC, MAA, and SA: collection, analysis, and interpretation of data, and drafting the manuscript. AM and DWL: interpretation of data, and critical revision of the manuscript. KTB: provide material preparation, supervision, and critical revision of the manuscript.

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Correspondence to Kevin T. Behm.

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Calini, G., Abdalla, S., Abd El Aziz, M.A. et al. Ileocolic resection for Crohn’s disease: robotic intracorporeal compared to laparoscopic extracorporeal anastomosis. J Robotic Surg 17, 2157–2166 (2023). https://doi.org/10.1007/s11701-023-01635-6

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