Abstract Background Over the past years, minimally invasive surgical approach for inflammatory bowel diseases (IBD) has been prioritized with increasing but still limited evidence supporting the use of robotic surgery. The data available are mainly dealing with rectal and colonic interventions whilst the experience with small bowel resections is scarce and the role of robotic surgery in patients with complicated ileocolonic disease is debated.Thus, the aim of this study was to analyse the outcomes of minimally invasive procedures, laparoscopic vs. robotic ileo-cecal resections in a prospective cohort of Crohn´s Disease (CD) patients. Methods All CD patients undergoing laparoscopic or robotic ileo-caecal resection in one referral IBD centre between August 2023 and November 2024 were included. Differences between the two groups in basic demographics, disease phenotype and duration, treatment at the time of surgery, nutritional status, number of previous surgeries and reason for surgery were analysed. Duration of surgery, time to first bowel movement, any short-term complications and hospital stay were compared between the two respective surgical approaches. The patients were assigned to laparoscopic or robotic group based on logistic availability. Results In total, 37 patients with CD were included (mean age 38 years, range 20-69; 17-47% were women; mean disease duration 7.3 years, range 0-37). Twenty-six patients were operated laparoscopically, 11 underwent robotic surgery. The two groups did not differ in any of the above-mentioned preprocedural characteristics, including the proportion of stenosing and penetrating phenotypes. There were no differences in nutritional status (mean BMI 22.6±0.84 vs. 22.4±1.1 in laparoscopic vs. robotic group, respectively, p=0.913) with weight loss prior surgery being equally present in both groups (11.5% vs. 9.1% in laparoscopic vs. robotic group, respectively, p>0.9999). Mean duration of the procedure was significantly longer in the robotic group (216 minutes, range 120-316 in the robotic group vs. 147 minutes, range 75-300 in laparoscopic group, respectively; p=0.002). The two groups did not differ in the mean hospital stay (6.3, range 4-14 vs. 5.6, range 4-8; laparoscopic vs. robotic surgery, respectively, p=0.331); nor in time to first bowel movement (1.9, range 1-4 vs. 2.4, range 1-4; laparoscopic vs. robotic group, respectively, p=0.14). There were two surgical site infections in the laparoscopic group and one ileus treated conservatively in the robotic group. Conclusion Robotic ileo-caecal resection is feasible in Crohn’s disease patients regardless of disease phenotype and the type of Crohn’s disease complication for which the surgery is performed.
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