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Session: ePoster: Benign Abdominal 1 (Sun8)

EP213 - A Rural Community Hospital Case Series: Robotic NICE Procedure – Alternative to Traditional Diverticulitis Surgery

Sunday, May 11, 2025
8:21 AM - 8:26 AM PT
Location: Monitor 2, Sails Pavilion, Upper Level

    ePoster Presenter(s)

  • Afia M. Wilson, MD (she/her/hers)

    Surgical Resident, PGY-3
    Mohawk Valley Health Systems
    Mohawk Valley Health Systems
    Rome, NY, United States

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

    View ePoster

    • Author(s)

  • JS

    Jonathan Stahl, D.O.

    Colon and Rectal surgeon
    Wynn hospital
    Utica, New York, United States

    Disclosure information not submitted.

  • MM

    Maurizio Miglietta, D.O., FACS

    Chief of Trauma & Critical Care
    Mohawk Valley Health System
    Point pleasant beach, New Jersey, United States

    Disclosure information not submitted.

All of the relevant financial relationships listed below have been mitigated.
Afia M. Wilson, MD: This individual has no financial relationships with ineligible companies.
Purpose/Background: At most centers, patients with sigmoid diverticulitis, who are candidates for elective surgery undergo conventional laparoscopic/robotic extracorporeal-assisted surgery. The NICE procedure is a completely intracorporeal anastomosis with extraction of the specimen through the rectum. Here we present four successful cases of Robotic NICE procedures for complicated diverticulitis, completed in at our rural community hospital, indicating the potential for future cases.

Methods/Interventions: Consecutive patients who presented with complicated diverticulitis – with fistula, abscess and/or stricture – who underwent the NICE procedure in April-July 2024 were evaluated. Intra-operative and post-operative data were collected and reviewed. The data extracted included demographic, clinical data, disease features, and outcomes data. The main outcomes assessed were operative time, time to return of bowel function, pain scales, and length of stay.

Results/Outcomes: Four patients underwent the NICE procedure electively for complicated recurrent diverticulitis. All cases required intricate dissection due to the complexity of their diseases and had successful intracorporeal anastomosis and extraction of specimen through the rectum. None experienced post-operative leaks or infections. The mean operative time was 342 minutes. Average time to bowel movement was 4.3 days. Average pain scales were 3.3 by post-operative day 3. Finally, the mean total length of stay was 5 days.

Conclusion/Discussion: We hypothesize the Robotic NICE procedure is a successful alternative to traditional diverticulitis surgery, without a negative effect on complication rates and better patient outcomes at our rural community hospital. Our greatest limitation is sample size; however, after these successful cases we perceive many more to come.

MVHS Robotic NICE Procedure Outcomes
Outcomes of NICE procedures including: operative, successful extraction, length of stay, time to flatus, time to bowel movement, and pain scales.

NICE Procedure Outcomes Trend
Trend of length of stay, time to flatus, and time to bowel movement.