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Minerva Chirurgica 2016 Ottobre;71(5):293-9

lingua: Inglese

Minimally invasive treatment of difficult bleeding lesions of the small bowel

Mario A. MASRUR 1, Despoina DASKALAKI 1, Andrea VANNUCCHI 1, Siddharth N. VANNEMREDDY 1, Luis F. GONZALEZ-CICCARELLI 1, Ross BROWN 2, Pier C. GIULIANOTTI 1

1 Division of General, Minimally Invasive and Robotic Surgery, Department of Surgery, University of Illinois, Chicago, IL, USA; 2 Department of Gastroenterology and Digestive Diseases, University of Illinois, Chicago, IL, USA


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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.

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