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Minimally Invasive Surgery in Crohn’s Disease Patients

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Minimally Invasive Approaches to Colon and Rectal Disease

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Abstract

Crohn’s disease patients are good candidates for minimally invasive (MI) surgery. This is primarily due to the benign nature of Crohn’s disease and the fact that the majority of patients are young and seek cosmetically acceptable outcomes. However, laparoscopic surgery in this cohort is technically challenging due to the inflammatory state of the bowel. A considerable number of case-control studies have demonstrated the short-term benefits of laparoscopic ileocolic resection. Recently, the technical feasibility and safety of MI surgery in patients with complex or recurrent Crohn’s disease has been reported by experienced surgeons. The presence of an intra-abdominal abscess or fistula, recurrent surgery, high dose of steroid administration, extracecal colonic disease, and malnutrition are factors associated with conversion to an open procedure. There are several technical pearls for laparoscopic colectomy for Crohn’s disease that improve the ease of the procedure. Most surgical procedures, including total proctocolectomy, can be performed safely in Crohn’s disease patients. However, with the exception of ileocolic resection, randomized controlled trials are needed to prove the short- and long-term benefits of MI surgery.

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Author information

Authors and Affiliations

  1. Department of Colon & Rectal Surgery, Asan Medical Center, University of Ulsan College of Medicine, 388-1 Poongnap-dong, Songpa-gu, Seoul, 138-736, Korea

    Chang Sik Yu M.D., Ph.D.

Authors
  1. Chang Sik Yu M.D., Ph.D.
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Corresponding author

Correspondence to Chang Sik Yu M.D., Ph.D. .

Editor information

Editors and Affiliations

  1. Division of Colon and Rectal Surgery Department of Surgery, Temple University Health System, Philadelphia, Pennsylvania, USA

    Howard M. Ross MD FACS FASCRS

  2. Division of Colon and Rectal Surgery, Department of Surgery, Weill-Cornell Medical College, New York Presbyterian Hospital, New York, New York, USA

    Sang W. Lee MD, FACS, FASCRS

  3. Department of Surgery, Washington University School of Medicine, St. Louis, Missouri, USA

    Matthew G. Mutch MD, FACS, FASCRS

  4. North Shore-LIJ Health System, Huntington Hospital, Hofstra University School of Medicine, Huntington, New York, USA

    David E. Rivadeneira MD, MBA,FACS, FASCRS

  5. Department of Colon & Rectal Surgery, Madigan Army Medical Center, Olympia, Washington, USA

    Scott R. Steele M.D., FACS, FASCRS

Electronic Supplementary Materials

Below is the link to the electronic supplementary material.

“Running the bowel” to evaluate for additional sites of active Crohn’s disease and measure length (MP4 82778 kb)

Laparoscopic ileocecectomy for complex Crohn’s disease. Video by Sharon Stein, MD (MP4 98651 kb)

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Yu, C.S. (2015). Minimally Invasive Surgery in Crohn’s Disease Patients. In: Ross MD FACS FASCRS, H., Lee MD, FACS, FASCRS, S., Mutch MD, FACS, FASCRS, M., Rivadeneira MD, MBA,FACS, FASCRS, D., Steele M.D., FACS, FASCRS, S. (eds) Minimally Invasive Approaches to Colon and Rectal Disease. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-1581-1_30

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  • DOI: https://doi.org/10.1007/978-1-4939-1581-1_30

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  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4939-1580-4

  • Online ISBN: 978-1-4939-1581-1

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