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Session: ePoster: IBD 4 (Mon1015)

EP733 - Transition from laparoscopic to robotic resections for inflammatory bowel disease: Single surgeon review of outcomes

Monday, May 12, 2025
10:58 AM – 11:03 AM PT

    ePoster Presenter(s)

  • Yadin Bornstein, MD

    Colorectal Surgery Fellow
    NYU Langone Health Medical Center
    New York, New York, United States

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

    • Senior Author(s)

  • Ad

    Andre da Luz Moreira, MD, PhD

    Clinical Associate Professor of Surgery
    NYU Grossman School of Medicine
    New York, New York, United States

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

    • Author(s)

  • Chady Atallah, MD

    Colorectal Surgeon
    NYU Langone Health Medical Center
    New York, New York, United States

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

  • JS

    Jessica N. Simon, MD

    Colorectal Surgeon
    NYU Langone Health Medical Center
    New York, New York, United States

    Disclosure information not submitted.

  • Mehmet Gulmez, MD

    Surgeon
    Northwell
    New york, New York, United States

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

  • FR

    Feza Remzi, MD

    Surgeon
    Hofstra Northwell Health
    New York, New York, United States

    Disclosure information not submitted.

  • MG

    Michael J. Grieco, MD

    Associate Professor of Surgery
    NYU Langone Health
    New York, New York, United States

    Disclosure information not submitted.

  • BS

    Bashar A. Safar, MD

    Colorectal Surgeon
    NYU Langone Health Medical Center
    New York, New York, United States

    Disclosure information not submitted.

All of the relevant financial relationships listed below have been mitigated.
Yadin Bornstein, MD: This individual has no financial relationships with ineligible companies.
Andre da Luz Moreira, MD, PhD: This individual has no financial relationships with ineligible companies.
Chady Atallah, MD: This individual has no financial relationships with ineligible companies.
Mehmet Gulmez, MD: This individual has no financial relationships with ineligible companies.
Image or Table (Do Not add text here):

Purpose/Background: The robotic platform can overcome many of the limitations of the laparoscopic approach which is especially important in complex inflammatory bowel disease (IBD) patients. Our study aimed to share a single surgeon experience with transitioning from laparoscopic to robotic surgery for IBD patients and to evaluate outcomes during this transition.

Methods/Interventions: We retrospectively identified consecutive patients who underwent ileocolic resection (ICR), total abdominal colectomy (TAC) and completion proctectomy with intersphincteric anusectomy (CP) for IBD using a purely robotic (R) or laparoscopic (L) approach between January 2021 and October 2024. All surgeries were performed by a single experienced IBD laparoscopic surgeon with an early experience with robotic platform ( < 30 cases overall). A chart review was performed, and the preoperative, intraoperative, and postoperative data were collected. Outcomes were operative time, conversion rate, 30-day postoperative morbidity and mortality, length of hospital stay, and readmission rate. Comparison of R and L was performed using chi-square or Fisher’s exact test for categorical data and the Wilcoxon rank sum test for quantitative data. An alpha level of 0.05 was used to establish the statistical significance of individual p values.

Results/Outcomes: A total of 153 patients with a mean age of 37.6 years old were identified, of which 52% were female. During the study period the single surgeon robotic surgical rates when compared to laparoscopic were 0% vs 100% in 2021, 35% vs 65% in 2022, 52% vs 48% in 2023 and 65% vs 35% in 2024, respectively. Diagnosis was Crohn’s disease in 72% and ulcerative colitis in 28% of the patients. R group had more Crohn’s disease patients than the L group (85% vs 63%, p< 0.01). The operations included 99 ICR (52 L vs 47 R), 49 TAC (38 L vs 11R) and 5 CP (3 L vs 2 R). The mean robotic docking time for ICR, TAC and CP was 75, 138 and 108 minutes, respectively. Laparoscopic and robotic ICR had comparable Crohn’s disease behavior (46% vs 43% penetrating phenotype, p= 0.3) and diversion rates (39% vs 32%, p= 0.4), however R group had significantly more intracorporeal anastomosis (37% vs 0%, p< 0.001). The overall length of stay (LOS) was 5.5 vs 5 days in the L and R groups respectively. (p = 0.06). However, LOS for ICR was significantly shorter in the R group when compared to the L group (5 vs 6 days, p=0.036). The mean overall operative time was longer in the robotic group (203 vs 172 minutes) and this difference was significant (p < 0.01). There were similar conversion rates (3% vs 8%, p=0.2), postoperative morbidity (27% vs. 23%; p = 0.6), reoperation (4.4% vs. 4.9%; p = 0.8) and readmission rates (4% vs. 6%; p = 0.6). No intraoperative complications nor postoperative mortality occurred in either group.

Conclusion/Discussion: The transition to robotic surgery for IBD appears to be safe and feasible for those who are facile with the laparoscopic approach. This was accomplished with no major morbidity or mortality, and one day shorter length of stay for ICR. The robotic approach may offer advantages in IBD which should be studied further in prospective studies.