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Fully Robotic Total Colectomy in High-Risk Patients and Review of Literature
Igor Monsellato1, Teresa Gatto1, Maria Antonietta Alagia1
1SCDU Chirurgia Generale, Oncologica, Robotica e HBP, AOUAL SS, Antonio e Biagio e Cesare Arrigo, Alessandria, Italy.
Background:
Robotic total colectomy is a valuable approach for managing complex colorectal diseases. Its role in high-risk patients, especially those with significant comorbidities or synchronous malignancy, remains underreported.
Methods:
Two high-risk male patients with familial adenomatous polyposis (FAP), one with synchronous colon cancer, underwent fully robotic total colectomy with intracorporeal ileo-pouch-rectal anastomosis and loop ileostomy using the da Vinci Xi system in 2024. A focused review of the recent literature on robotic colectomy was also conducted.
Results:
The mean age was 68 years, and mean BMI was 33.05 kg/m2. One patient had cirrhosis and obesity; the other had severe obesity and psychiatric comorbidity. Both procedures were completed without conversions or complications. Mean console time was 315 min, and mean hospital stay was 11 days.
Conclusions:
Fully robotic total colectomy is feasible and safe in high-risk patients. These findings support its expanded role in minimally invasive colorectal surgery.
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