Minimally invasive surgery for inflammatory bowel disease. 2015

Jennifer Holder-Murray, and Priscilla Marsicovetere, and Stefan D Holubar
*Department of Surgery, Division of Colon and Rectal Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania; and †Division of Colon and Rectal Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire.

Surgical management of inflammatory bowel disease is a challenging endeavor given infectious and inflammatory complications, such as fistula, and abscess, complex often postoperative anatomy, including adhesive disease from previous open operations. Patients with Crohn's disease and ulcerative colitis also bring to the table the burden of their chronic illness with anemia, malnutrition, and immunosuppression, all common and contributing independently as risk factors for increased surgical morbidity in this high-risk population. However, to reduce the physical trauma of surgery, technologic advances and worldwide experience with minimally invasive surgery have allowed laparoscopic management of patients to become standard of care, with significant short- and long-term patient benefits compared with the open approach. In this review, we will describe the current state-of the-art for minimally invasive surgery for inflammatory bowel disease and the caveats inherent with this practice in this complex patient population. Also, we will review the applicability of current and future trends in minimally invasive surgical technique, such as laparoscopic "incisionless," single-incision laparoscopic surgery (SILS), robotic-assisted, and other techniques for the patient with inflammatory bowel disease. There can be no doubt that minimally invasive surgery has been proven to decrease the short- and long-term burden of surgery of these chronic illnesses and represents high-value care for both patient and society.

UI MeSH Term Description Entries
D010535 Laparoscopy A procedure in which a laparoscope (LAPAROSCOPES) is inserted through a small incision near the navel to examine the abdominal and pelvic organs in the PERITONEAL CAVITY. If appropriate, biopsy or surgery can be performed during laparoscopy. Celioscopy,Laparoscopic Surgical Procedures,Peritoneoscopy,Surgical Procedures, Laparoscopic,Laparoscopic Assisted Surgery,Laparoscopic Surgery,Laparoscopic Surgical Procedure,Procedure, Laparoscopic Surgical,Procedures, Laparoscopic Surgical,Surgery, Laparoscopic,Surgical Procedure, Laparoscopic,Celioscopies,Laparoscopic Assisted Surgeries,Laparoscopic Surgeries,Laparoscopies,Peritoneoscopies,Surgeries, Laparoscopic,Surgeries, Laparoscopic Assisted,Surgery, Laparoscopic Assisted
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D013505 Digestive System Surgical Procedures Surgery performed on the digestive system or its parts. Gastrointestinal Surgical Procedures,Digestive System Surgical Procedure,Gastrointestinal Surgical Procedure,Procedure, Digestive System Surgical,Procedure, Gastrointestinal Surgical,Procedures, Digestive System Surgical,Procedures, Gastrointestinal Surgical,Surgical Procedure, Digestive System,Surgical Procedure, Gastrointestinal,Surgical Procedures, Digestive System,Surgical Procedures, Gastrointestinal
D015212 Inflammatory Bowel Diseases Chronic, non-specific inflammation of the GASTROINTESTINAL TRACT. Etiology may be genetic or environmental. This term includes CROHN DISEASE and ULCERATIVE COLITIS. Bowel Diseases, Inflammatory,Inflammatory Bowel Disease
D019060 Minimally Invasive Surgical Procedures Procedures that avoid use of open, invasive surgery in favor of closed or local surgery. These generally involve use of laparoscopic devices and remote-controlled manipulation of instruments with indirect observation of the surgical field through an endoscope or similar device. Minimal Access Surgical Procedures,Minimal Surgical Procedures,Minimally Invasive Surgical Procedure,Surgical Procedures, Minimally Invasive,Minimal Surgical Procedure,Minimally Invasive Surgery,Procedure, Minimal Surgical,Procedures, Minimal Access Surgical,Procedures, Minimal Surgical,Procedures, Minimally Invasive Surgical,Surgical Procedure, Minimal,Surgical Procedures, Minimal,Surgical Procedures, Minimal Access,Minimally Invasive Surgeries,Surgeries, Minimally Invasive,Surgery, Minimally Invasive

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