Abstract：
Restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA) has become standard surgical treatment of choice in patients with ulcerative colitis (UC) and familial adenomatous polyposis (FAP) in which the medical management fails. Despite the wide use of laparoscopic method, the enhanced and innovative features that come with the robotic platform, such as endo-wrist technology, 3D visualization, surgeon-controlled camera and motion scaling, make it an appealing choice. This study aims to investigate the feasibility and safety of robotic approach for proctectomy or proctocolectomy with IPAA as compared to conventional laparoscopic approach. A systematic review was completed for studies done between 2010 and 2022 comparing the robotic approach with the laparoscopic approach. Nine studies were found to be feasible to be included in this review. In terms of the outcomes, although the mean operating time was slightly higher than the laparoscopic approach, the other outcomes, such as mean blood loss, return of the bowel movement, mean hospital stay, and conversion to open, were found to be significantly lower in the robotic approach as compared to both laparoscopic and conventional open techniques. Despite the overall increased rate of complications combined from all the studies, the rate of significant complications such as anastomotic leaks requiring readmission and return to theater was also found to be substantially less. This study concludes that although robotic approach is in its initial stages for pelvic surgeries, it can be safely employed due to improved dexterity and visibility.
摘要：
回肠袋-肛门吻合术（IPAA）的恢复性直肠结肠切除术已成为溃疡性结肠炎（UC）和家族性腺瘤性息肉病（FAP）患者的标准手术治疗选择，其中医疗管理失败。尽管广泛使用腹腔镜方法，机器人平台带来的增强和创新功能，例如endo手腕技术，3D可视化,外科医生控制的摄像头和运动缩放，让它成为一个有吸引力的选择。本研究旨在研究与传统腹腔镜方法相比，机器人方法用于IPAA直肠切除术或结直肠切除术的可行性和安全性。对2010年至2022年之间进行的比较机器人方法与腹腔镜方法的研究进行了系统评价。九项研究被认为是可行的纳入本综述。就结果而言，尽管平均手术时间略高于腹腔镜手术，其他结果，比如平均失血，肠蠕动恢复,平均住院时间，并转换为开放，与腹腔镜和传统的开放技术相比，机器人方法明显更低。尽管所有研究的并发症发生率总体上增加了，诸如需要重新入院和返回手术室的吻合口瘘等重大并发症的发生率也大大降低。这项研究得出的结论是，尽管机器人方法还处于骨盆手术的初始阶段，它可以安全地使用，由于提高了灵活性和能见度。
