Background/Hypothesis: Few studies have reported minimally invasive total proctocolectomy with ileal pouch–anal anastomosis (IPAA) for familial adenomatous polyposis (FAP). We present a case of hybrid - hand assisted laparoscopic - robotic surgery (HALRS) in total proctocolectomy with ileal pouch-anal anastomosis for familiar adenomatous polyposis. Materials and Methods: An 18-years old man affected by Familiar Adenomatous Polyposis. The first step of the operation consisted in hand assisted laparoscopic full mobilization of the entire colon. The procedure was then carried out with Da Vinci Surgical System© in the second step, for proctectomy throughout the pelvic cavity till the elevator plane. The ileal pouch was fashioned throughout a Pfannenstiel incision to size the length of the pouch. Finally, the ileal-anal anastomosis was created trans-anally. Results: The procedure was successfully completed in 370 min. There were no surgical complications or a need for conversion to laparotomy. The patient had an uneventful recovery and he was discharged from hospital after 6 days. Conclusions: The hybrid approach to total proctocolectomy with IPAA is safe and feasible and permits to gain the traditional benefits of a minimally invasive approach surpassing most of the limitations of a pure laparoscopic or robotic techniques. Further experience is necessary to refine the technique and fully assess its potential advantages.

HYBRID - HAND ASSISTED LAPAROSCOPIC - ROBOTIC SURGERY (HALRS) IN TOTAL PROCTOCOLECTOMY WITH ILEAL POUCH-ANAL ANASTOMOSIS FOR FAMILIAR ADENOMATOUS POLYPOSIS

PALMERI, MATTEO;DI FRANCO, GREGORIO;GUADAGNI, SIMONE;BIANCHINI, MATTEO;GIANARDI, DESIRÉE;FURBETTA, NICCOLO';D'ISIDORO, CRISTIANO;DI CANDIO, GIULIO;MOSCA, FRANCO;MORELLI, LUCA
2016-01-01

Abstract

Background/Hypothesis: Few studies have reported minimally invasive total proctocolectomy with ileal pouch–anal anastomosis (IPAA) for familial adenomatous polyposis (FAP). We present a case of hybrid - hand assisted laparoscopic - robotic surgery (HALRS) in total proctocolectomy with ileal pouch-anal anastomosis for familiar adenomatous polyposis. Materials and Methods: An 18-years old man affected by Familiar Adenomatous Polyposis. The first step of the operation consisted in hand assisted laparoscopic full mobilization of the entire colon. The procedure was then carried out with Da Vinci Surgical System© in the second step, for proctectomy throughout the pelvic cavity till the elevator plane. The ileal pouch was fashioned throughout a Pfannenstiel incision to size the length of the pouch. Finally, the ileal-anal anastomosis was created trans-anally. Results: The procedure was successfully completed in 370 min. There were no surgical complications or a need for conversion to laparotomy. The patient had an uneventful recovery and he was discharged from hospital after 6 days. Conclusions: The hybrid approach to total proctocolectomy with IPAA is safe and feasible and permits to gain the traditional benefits of a minimally invasive approach surpassing most of the limitations of a pure laparoscopic or robotic techniques. Further experience is necessary to refine the technique and fully assess its potential advantages.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11568/807679
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