Initial Case Series of Robot-assisted Restorative Proctocolectomy with Ileal Pouch-anal Anastomosis for Ulcerative Colitis-associated Neoplasia.
- 1Department of Digestive Tract and General Surgery, Saitama Medical Center, Saitama Medical University, Saitama, Japan.
- 2Department of Clinical Genetics, Saitama Medical Center, Saitama Medical University, Saitama, Japan.
Abstract
Interest in minimally invasive surgery has increased in various surgeries, including restorative proctocolectomy (RPC) with ileal pouch-anal anastomosis (IPAA). Robot-assisted surgery has been introduced as the latest minimally invasive approach to overcome the limitations of conventional laparoscopic surgery. However, evidence regarding robot-assisted RPC with IPAA is scarce. This study aimed to describe the technique of robot-assisted RPC with IPAA for UC-associated neoplasia (UCAN), evaluate its short-term outcomes, and examine the procedural efficiency. Data were collected prospectively for consecutive operations between May 2021 and May 2025, including all cases of robot-assisted RPC with IPAA for patients with UCAN. Eleven patients with UCAN underwent robot-assisted RPC with IPAA (stapled IPAA n=9; handsewn IPAA n=2); six stapled IPAA cases were one-stage surgery without ileostomy. The median operating time was 349 minutes, and the blood loss was 24 mL. Median postoperative hospital stay was 10 days. There was no conversion to open surgery. There was no anastomotic leakage. Clavien-Dindo grade IIIa complications occurred in three patients (one outlet obstruction and two anastomotic stricture); nevertheless, all events were resolved conservatively with short-term bedside decompression tube placement. Procedural efficiency, assessed as console time normalized by BMI, improved with case accrual, reflecting a favorable learning curve. This initial study has demonstrated the feasibility of robot-assisted RPC with IPAA for UCAN. This approach may allow reduction of residual rectal mucosa and, with appropriate patient selection, omission of a temporary diverting stoma.
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BibTeX
@article{matsuyama2026initial,
title = {{Initial Case Series of Robot-assisted Restorative Proctocolectomy with Ileal Pouch-anal Anastomosis for Ulcerative Colitis-associated Neoplasia.}},
author = {Takatoshi Matsuyama and Noriyasu Chika and Takehiro Shiraishi and Yoshiko Mori and Youichi Kumagai and Hideyuki Ishida},
journal = {Journal of the anus, rectum and colon},
year = {2026},
month = oct,
doi = {10.23922/jarc.2026-001},
url = {https://europepmc.org/article/MED/42952677},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Initial Case Series of Robot-assisted Restorative Proctocolectomy with Ileal Pouch-anal Anastomosis for Ulcerative Colitis-associated Neoplasia.
AU - Takatoshi Matsuyama
AU - Noriyasu Chika
AU - Takehiro Shiraishi
AU - Yoshiko Mori
AU - Youichi Kumagai
AU - Hideyuki Ishida
PY - 2026
DA - 2026/10/25
JO - Journal of the anus, rectum and colon
DO - 10.23922/jarc.2026-001
UR - https://europepmc.org/article/MED/42952677
AB - Interest in minimally invasive surgery has increased in various surgeries, including restorative proctocolectomy (RPC) with ileal pouch-anal anastomosis (IPAA). Robot-assisted surgery has been introduced as the latest minimally invasive approach to overcome the limitations of conventional laparoscopic surgery. However, evidence regarding robot-assisted RPC with IPAA is scarce. This study aimed to describe the technique of robot-assisted RPC with IPAA for UC-associated neoplasia (UCAN), evaluate its short-term outcomes, and examine the procedural efficiency. Data were collected prospectively for consecutive operations between May 2021 and May 2025, including all cases of robot-assisted RPC with IPAA for patients with UCAN. Eleven patients with UCAN underwent robot-assisted RPC with IPAA (stapled IPAA n=9; handsewn IPAA n=2); six stapled IPAA cases were one-stage surgery without ileostomy. The median operating time was 349 minutes, and the blood loss was 24 mL. Median postoperative hospital stay was 10 days. There was no conversion to open surgery. There was no anastomotic leakage. Clavien-Dindo grade IIIa complications occurred in three patients (one outlet obstruction and two anastomotic stricture); nevertheless, all events were resolved conservatively with short-term bedside decompression tube placement. Procedural efficiency, assessed as console time normalized by BMI, improved with case accrual, reflecting a favorable learning curve. This initial study has demonstrated the feasibility of robot-assisted RPC with IPAA for UCAN. This approach may allow reduction of residual rectal mucosa and, with appropriate patient selection, omission of a temporary diverting stoma.
SN - 2432-3853
ER -