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Published on: December 20, 2024
Minimally invasive treatment of difficult bleeding lesions of the small bowel
Mario Masrur1, Despoina Daskalaki, Andrea Vannucchi
1Division of General, Minimally Invasive and Robotic Surgery, Department of Surgery, University of Illinois, Chicago, IL, USA - mmasrur@uic.edu.
Background:
Bleeding Lesions of the small bowel are often difficult to identify due to the obscure symptomatology. Localizing these lesions requires specific techniques. The Double- balloon enteroscopy (DBE) could be used to precisely localize and mark lesions, so that a minimally invasive surgical treatment could be performed.
Patients & Methods:
20 robot-assisted small bowel procedures are presented using a combination of DBE for localization and robotic resection.
Results:
There were 10 jejunal resections and 10 ileal resections. Mean age was 58.7 years. Mean operative time was 153.4 minutes, mean blood loss of 46 ml. No conversion-to-open and there were 4 post-operative complications. The 90-day mortality was nil and the median LOS was 4.1 days. Final pathology was consistent with malignancy in 10 cases.
Conclusions:
The combination of double balloon enteroscopy and robotic technology allows accurate identification and selective treatment of lesions that could be otherwise difficult to treat in a minimally invasive fashion.
Insights
Double-balloon enteroscopy (DBE) combined with robotic surgery precisely locates and treats difficult small bowel lesions. This minimally invasive approach offers accurate diagnosis and effective management for conditions like malignancy.
Area of Science:
- Minimally Invasive Surgery
- Gastroenterology
- Surgical Robotics
Background:
- Small bowel bleeding lesions present diagnostic challenges due to subtle symptoms.
- Accurate localization is crucial for effective treatment.
- Double-balloon enteroscopy (DBE) offers a method for precise lesion identification and marking.
Purpose of the Study:
- To evaluate the efficacy of combining DBE with robotic-assisted surgery for small bowel lesions.
- To assess the feasibility and outcomes of this minimally invasive approach.
Main Methods:
- Twenty robot-assisted small bowel procedures were performed.
- Double-balloon enteroscopy (DBE) was utilized for lesion localization prior to robotic resection.
- Procedures included 10 jejunal and 10 ileal resections.
Main Results:
- Mean operative time was 153.4 minutes with minimal blood loss (46 ml).
- No conversions to open surgery were required, with 4 post-operative complications.
- Median length of stay was 4.1 days, with no 90-day mortality.
- Malignancy was confirmed in 10 cases.
Conclusions:
- The combination of DBE and robotic technology enables accurate identification and selective treatment of challenging small bowel lesions.
- This integrated approach facilitates minimally invasive surgical management.
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