Robotic surgery in inflammatory bowel disease: a systematic review

Surgical treatment remains an essential component in the management of inflammatory bowel disease (IBD) despite advances in medical therapy. Although minimally invasive surgery is preferred, technical challenges related to chronic inflammation and altered anatomy may limit laparoscopic approaches. Robotic surgery has been increasingly adopted, but its role in IBD surgery remains to be clearly defined.

To synthesize the available evidence on the feasibility, safety, and perioperative outcomes of robotic surgery in patients with IBD.

A systematic review was conducted according to PRISMA guidelines. Studies were identified through an electronic search of the PubMed database for reports evaluating outcomes of robotic surgery in IBD. Eligible studies included case series, comparative studies, and systematic reviews published in English. Primary outcomes were conversion to open surgery and postoperative complications; secondary outcomes included operative time, length of stay (LOS), reoperation, readmission, and anastomotic leak.

Thirty-four studies were included. Robotic surgery was consistently associated with longer operative time. However, postoperative morbidity, major complications, anastomotic leak, reoperation, and mortality rates were comparable between techniques. Robotic approaches demonstrated lower and favorable conversion rates, particularly in complex inflammatory phenotypes or pelvic procedures. Length of stay and estimated blood loss were similar or numerically lower in several robotic cohorts.

Robotic surgery is a safe and feasible minimally invasive approach for IBD patients, with perioperative outcomes comparable to conventional surgery. Its potential advantages may be most relevant in complex or technically demanding cases, although high-quality prospective studies are needed to better define its role.