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Video

Session: Ongoing Videos

VM44 - Robotic Ileostomy Reversal with Intracorporal Ileocolonic Anastomosis

ONGOING VIDEOS
Location: San Diego Convention Center, ASCRS Connect Lounge, Hall B1/B2, Ground Level

    Video Presentation(s)

  • Andrew Hu, MD

    Mark Kusek Colorectal Research Fellow
    UMass Chan Medical School
    Worcester, MA, United States

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

    • Author(s)

  • Benjamin Gallant, MD

    Resident
    UMass Chan Medical School
    Leicester, MA, United States

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

  • SR

    Samantha Rivard, MD

    Colorectal Surgeon
    Boston Medical Center
    North Reading, Massachusetts, United States

    Disclosure information not submitted.

    • Senior Author(s)

  • TP

    Thomas Peponis, MD

    Colon and Rectal Surgeon, Assistant Professor of Surgery
    University of Massachusetts
    Worcester, Massachusetts, United States

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

All of the relevant financial relationships listed below have been mitigated.
Andrew Hu, MD: This individual has no financial relationships with ineligible companies.
Benjamin Gallant, MD: This individual has no financial relationships with ineligible companies.
Thomas Peponis, MD: This individual has no financial relationships with ineligible companies.
Image or Table (Do Not add text here):

Purpose/Background: Minimally invasive approaches to end ileostomy reversal are a viable alternative to open surgery and can prove useful particularly in patients with significant visceral adiposity. While videos have demonstrated the robotic takedown of end colostomy, visual depictions of robotic end ileostomy reversal with intracorporeal anastomosis are currently lacking. We aim to depict the steps of a robotic end ileostomy reversal with intracorporeal ileocolonic anastomosis.

Methods/Interventions: We present a case of robotic end ileostomy reversal with intracorporeal ileocolonic anastomosis in an obese patient. The patient had a prior history of stricturing and fistulizing Crohn’s disease who failed medical management. They previously underwent a laparoscopic ileocecectomy with end ileostomy creation.

Results/Outcomes: The patient was instructed to hold their Janus kinase (JAK) inhibitor 14 days preoperatively. Immediately preoperatively, the Urology team assisted with ureteral identification by performing bilateral ureteral injections of indocyanine green (ICG) and placing temporary bilateral ureteral stents. The stents were removed following completion of the case. Postoperatively, the patient progressed appropriately and experienced no immediate postoperative complications. They had return of bowel function on postoperative day one and they were discharged home on postoperative day two. They resumed the JAK inhibitor approximately one month postoperatively.

Conclusion/Discussion: The robotic-assisted approach can prove valuable in end ileostomy reversal. Specifically our robotic-assisted technique for end ileostomy reversal with intracorporeal anastomosis presents an option in obese patients with interloop adhesive disease. This minimally invasive approach has the potential to reduce hospital length of stay and hernia formation as well as minimize pain and narcotic use in these patients.