Robotic Treatment of Inflammatory Diseases

Inflammatory bowel disease (IBD) is a group of immune-mediated bowel conditions, predominantly Crohn’s disease (CD) and ulcerative colitis (UC), significantly affecting patients’ quality of life. This chapter explores the evolving landscape of IBD management. With the emergence of novel therapeutic agents and a multidisciplinary approach, surgeons have become pivotal early in the disease course. At the same time, the advances in disease understanding, diagnostics, and surgical technology have enhanced treatment outcomes. Surgical candidates with IBD present unique risk factors, regardless of age, often accompanied by malnutrition and related comorbidities. Addressing fertility, sexual function, and continence preservation is paramount, particularly given the young age at diagnosis. Despite declining surgery rates in recent decades, the global demand for IBD surgery is rising, reflecting the increasing prevalence of diagnoses. Traditional open surgery, long considered the gold standard, offers tactile benefits in distinguishing healthy and affected tissues. Nevertheless, the expanding adoption of minimally invasive surgery (MIS) in IBD cases has shown promise in reducing adhesion formation, pain, and length of hospitalization. In the context of MIS, robotic surgery is gaining prominence for its potential to improve surgical outcomes. Two main concepts of robotic surgery exist. The first is based on a monolithic system including all the robotic arms and tools, the second is centered on flexibility and scalability, with independent robotic wheeled units that can be deployed independently and possibly moved freely into the operative room. More recent surgical platforms have adopted this second concept. These novel robotic platforms have the potential to provide surgeons with more flexibility and dexterity in complex and challenging cases, such as those of a typical IBD patient. However, further studies are needed to assess their full potential and to identify the best settings for their use.