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Published on: December 20, 2024
Minimally invasive treatment of difficult bleeding lesions of the small bowel
Mario A 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.
Methods:
Twenty 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 length of stay 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 small bowel lesions. This minimally invasive approach offers accurate diagnosis and effective management for challenging gastrointestinal conditions.
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 precise lesion identification and marking.
Purpose of the Study:
- To evaluate the efficacy of combining DBE with robotic-assisted surgery.
- To assess the feasibility of minimally invasive treatment for small bowel lesions.
Main Methods:
- Twenty robot-assisted small bowel procedures were performed.
- Procedures utilized DBE for lesion localization followed by robotic resection.
- Included jejunal and ileal resections.
Main Results:
- Successful completion of 20 procedures with no open conversions.
- Average operative time was 153.4 minutes with minimal blood loss (46 mL).
- Low complication rate (4 cases) and no 90-day mortality; median hospital stay was 4.1 days.
Conclusions:
- The combination of DBE and robotic technology enables accurate identification of small bowel lesions.
- This integrated approach facilitates selective, minimally invasive surgical treatment.
- It offers a viable solution for difficult-to-treat gastrointestinal conditions.
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