J Robot Surg. 2026 Jan 5;20(1):152. doi: 10.1007/s11701-025-03123-5.
ABSTRACT
Minimally invasive ileal pouch-anal anastomosis (IPAA) is the standard restorative procedure for ulcerative colitis (UC) requiring surgery. The clinical impact of the robotic approach remains uncertain. This study aimed to compare perioperative and long-term functional outcomes following robotic versus laparoscopic IPAA in two high-volume tertiary centers. This bicenter retrospective study included consecutive patients who underwent restorative proctocolectomy (RPC-IPAA) or restorative proctectomy (RP-IPAA) with IPAA for UC between 2012 and 2024. Patients were classified into robotic or laparoscopic groups. Perioperative outcomes included operative time, intraoperative complications, conversion to open, postoperative morbidity, and length of hospital stay. Functional results using the IPSS-20 score were evaluated at one year. One hundred and one patients were included, 58 (57.4%) in the laparoscopic group and 43 (42.6%) in the robotic group. Preoperative characteristics were comparable. Operative time was longer in robotic RP-IPAA (342 ± 70 vs. 300 ± 97 min, p = 0.013). Intraoperative complication (5%) and conversion (10.9%) rates did not differ between groups. Overall postoperative morbidity was 45.5%, with 13.9% severe complications, and similar between approaches. Absence of diverting ileostomy was the only factor associated with postoperative morbidity (p = 0.025). Length of hospital stay was shorter after robotic surgery (9.6 ± 4.0 vs. 12.8 ± 6.8 days, p = 0.005). At 1 year, pouchitis and cuffitis occurred in 23.2% and 4.7%, respectively, with comparable incidence between groups. IPSS-20 functional scores did not differ. Robotic IPAA is safe and feasible, providing perioperative and functional outcomes equivalent to laparoscopy while significantly reducing hospital stay. These findings support its use in expert centers.
PMID:41486330 | DOI:10.1007/s11701-025-03123-5
