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Background <p>Restorative proctocolectomy with ileal pouch–anal anastomosis (IPAA) is the standard surgical option for patients with ulcerative colitis (UC) wishing to avoid a permanent ileostomy. Single-port (SP) robotic surgery offers enhanced dexterity and visualization, potentially overcoming the limitations of single-port laparoscopy in the confined pelvic cavity. Its role in IPAA for UC is unexplored.</p> Methods <p>Patients with ulcerative colitis undergoing SP robotic proctectomy with IPAA at a tertiary center between October 2024 and June 2025 were reviewed. Procedures followed a standardized three-step approach with transanal transection single stapled (TTSS) anastomosis. Feasibility was defined as completion of the procedure without unplanned conversion to multiport laparoscopy, laparotomy, or transanal minimally invasive surgery (TAMIS). Safety by 30-day postoperative morbidity, readmission, and pouch leak rates was analyzed.</p> Results <p>A total of 14 patients (median age 34&#xa0;years; body mass index (BMI) 26.2&#xa0;kg/m<sup>2</sup>) were included. Median operative time was 237&#xa0;min (range 188–317 min). Hospital stay was 5.8&#xa0;days (range 3–12 days). No conversions occurred; one case required the unplanned placement of additional 5-mm assistant trocar. Four patients (28.5%) developed postoperative complications. The mean Comprehensive Complication Index was 7.6 ± 12.8 (SD). Three patients (21.4%) required readmission within 30&#xa0;days postoperatively. All patients underwent ileostomy closure at a median of 64&#xa0;days after IPAA creation.</p> Conclusions <p>SP robotic proctectomy with IPAA is feasible and safe in unselected patients with UC, supporting further large prospective evaluation.</p>

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Single-port robotic restorative proctectomy with ileal pouch–anal anastomosis for ulcerative colitis: first clinical experience and technical insights

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年12月24日

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  • Gabriele Bislenghi,
  • Albert Wolthuis,
  • André D’Hoore

摘要

Background

Restorative proctocolectomy with ileal pouch–anal anastomosis (IPAA) is the standard surgical option for patients with ulcerative colitis (UC) wishing to avoid a permanent ileostomy. Single-port (SP) robotic surgery offers enhanced dexterity and visualization, potentially overcoming the limitations of single-port laparoscopy in the confined pelvic cavity. Its role in IPAA for UC is unexplored.

Methods

Patients with ulcerative colitis undergoing SP robotic proctectomy with IPAA at a tertiary center between October 2024 and June 2025 were reviewed. Procedures followed a standardized three-step approach with transanal transection single stapled (TTSS) anastomosis. Feasibility was defined as completion of the procedure without unplanned conversion to multiport laparoscopy, laparotomy, or transanal minimally invasive surgery (TAMIS). Safety by 30-day postoperative morbidity, readmission, and pouch leak rates was analyzed.

Results

A total of 14 patients (median age 34 years; body mass index (BMI) 26.2 kg/m2) were included. Median operative time was 237 min (range 188–317 min). Hospital stay was 5.8 days (range 3–12 days). No conversions occurred; one case required the unplanned placement of additional 5-mm assistant trocar. Four patients (28.5%) developed postoperative complications. The mean Comprehensive Complication Index was 7.6 ± 12.8 (SD). Three patients (21.4%) required readmission within 30 days postoperatively. All patients underwent ileostomy closure at a median of 64 days after IPAA creation.

Conclusions

SP robotic proctectomy with IPAA is feasible and safe in unselected patients with UC, supporting further large prospective evaluation.