Does robotic‑assisted total colectomy reduce conversion to open surgery compared with conventional laparoscopic total colectomy in UC

What is known

- A narrative review states robotic subtotal colectomy is associated with lower conversion rates and earlier return of bowel function, with longer operative time, than laparoscopic. ¹ - A single-center proctectomy/IPAA cohort reported robotic conversion 3.4% versus laparoscopic 10.5%, but the difference was not statistically significant and the cohort may have been underpowered. ² - A meta-analysis of robotic versus laparoscopic IBD surgery found no difference in conversion rates, though robotic had lower overall complications and longer operative time. ³ - A nationwide readmission-database analysis found no significant difference in short-term clinical outcomes between robotic and laparoscopic IPAA, not corroborating earlier single-center conversion advantages. ⁴

What is unknown / caveats

- Single-center and narrative sources report lower robotic conversion; meta-analysis and nationwide data show no difference - One cited proctectomy/IPAA study (Rencuzogullari) found no reduced conversion with robotics - Reduced-conversion signals come largely from single-center cohorts and a narrative review; the supportive cohort finding was not statistically significant - Several sources address proctectomy/IPAA rather than total colectomy specifically - The signal favoring robotics comes from smaller single-center data, while larger pooled and nationwide analyses show no significant conversion difference.

## References

1. Anderson M, Grucela A. Robotic Surgery for Ulcerative Colitis. Clin Colon Rectal Surg. 2021;34:292-296. PMID: 35069021.

2. Gebhardt JM, Werner N, Stroux A, Förster F, Pozios I, Seifarth C, Schineis C, Kamphues C, Weixler B, Beyer K, Lauscher JC. Robotic-Assisted versus Laparoscopic Proctectomy with Ileal Pouch-Anal Anastomosis for Ulcerative Colitis: An Analysis of Clinical and Financial Outcomes from a Tertiary Referral Center. J Clin Med. 2022;11:ePub only. PMID: 36362789.

3. Zaman S, Mohamedahmed AYY, Abdelrahman W, Abdalla HE, Wuheb AA, Issa MT, Faiz N, Yassin NA. Minimally Invasive Surgery for Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis of Robotic Versus Laparoscopic Surgical Techniques. J Crohns Colitis. 2024;18(8):1342-1355. PMID: 38466108.

4. Lee MH, Chang YY. Robotic versus laparoscopic ileal pouch-anal anastomosis for ulcerative colitis: an analysis of the Nationwide readmission database, 2016-2020. Tech Coloproctol. 2026. PMID: 42120745.

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_Draft, generated by the IBDology RAG and not yet clinician-reviewed. Answers are grounded in the retrieved literature listed above; a high faithfulness score means the answer matches its sources, not that the sources are correct._