Hand-assisted hybrid laparoscopic–robotic total proctocolectomy with ileal pouch–anal anastomosis
Autor: | Maria Donatella Mariniello, Ugo Boggi, Cristiano D'Isidoro, E Marciano, Simone Guadagni, Giulio Di Candio, Giovanni Caprili, Niccolò Furbetta, Roberta Pisano, Luca Morelli, Franco Mosca |
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Rok vydání: | 2015 |
Předmět: |
Adult
Male Laparoscopic surgery medicine.medical_specialty medicine.medical_treatment Colonic Pouches Anastomosis Inflammatory bowel disease Da Vinci Surgical System Young Adult Ileal pouch–anal anastomosis Robotic Surgical Procedures Laparotomy medicine Hand-Assisted Laparoscopy Humans Retrospective Studies Colectomy Familial adenomatous polyposis business.industry Proctocolectomy General surgery Proctocolectomy Restorative Robotic proctectomy Surgery Hand-assisted laparoscopic surgery Treatment Outcome Adenomatous Polyposis Coli Colitis Ulcerative Female Pouch business |
Zdroj: | Langenbeck's Archives of Surgery. 400:741-748 |
ISSN: | 1435-2451 1435-2443 |
Popis: | Few studies have reported minimally invasive total proctocolectomy with ileal pouch–anal anastomosis (IPAA) for ulcerative colitis (UC) and familial adenomatous polyposis (FAP). We herein report a novel hand-assisted hybrid laparoscopic–robotic technique for patients with FAP and UC. Between February 2010 and March 2014, six patients underwent hand-assisted hybrid laparoscopic–robotic total proctocolectomy with IPAA. The abdominal colectomy was performed laparoscopically with hand assistance through a transverse suprapubic incision, also used to fashion the ileal pouch. The proctectomy was carried out with the da Vinci Surgical System. The IPAA was hand-sewn through a trans-anal approach. The procedure was complemented by a temporary diverting loop ileostomy. The mean hand-assisted laparoscopic surgery (HALS) time was 154.6 (±12.8) min whereas the mean robotic time was 93.6 (±8.1) min. In all cases, a nerve-sparing proctectomy was performed, and no conversion to traditional laparotomy was required. The mean postoperative hospital stay was 13.2 (±7.4) days. No anastomotic leakage was observed. To date, no autonomic neurological disorders have been observed with a mean of 5.8 (±1.3) bowel movements per day. The hand-assisted hybrid laparoscopic–robotic approach to total proctocolectomy with IPAA has not been previously described. Our report shows the feasibility of this hybrid approach, which surpasses most of the limitations of pure laparoscopic and robotic techniques. Further experience is necessary to refine the technique and fully assess its potential advantages. |
Databáze: | OpenAIRE |
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